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Martell Mcdaniel
Counselor in Centralia, Illinois
NPI 1902367105

Martell Mcdaniel is a Counselor based in Centralia, IL. Martell Mcdaniel practices in Centralia, IL. The NPI Number for Martell Mcdaniel is 1902367105 and holds a License No. (Illinois).

The current practice location address for Martell Mcdaniel is 904 E Martin Luther King Drive, Centralia, IL and can be reached out via phone at 618-533-1391 and via fax at 618-533-0012.

Location: 904 E Martin Luther King Drive, Centralia, IL, 62801-3058
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902367105
Provider Name
Martell Mcdaniel
Credential
Provider Entity Type
Individual
Gender
Male
Address
904 E Martin Luther King Drive, Centralia, IL, 62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
Provider Enumeration Date
03/29/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370915481007 05 IL
institution
Provider Business Practice Location Address Details
Address
904 E Martin Luther King Drive
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider Business Mailing Address Details
Address
904 E Martin Luther King Drive
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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