Provider Demographics
NPI:1447673850
Name:TERLONGE, DANIEL KEITH (LPCC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KEITH
Last Name:TERLONGE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 MERRIMAN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5210
Mailing Address - Country:US
Mailing Address - Phone:330-777-0610
Mailing Address - Fax:330-685-9006
Practice Address - Street 1:1653 MERRIMAN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5210
Practice Address - Country:US
Practice Address - Phone:330-777-0610
Practice Address - Fax:330-685-9006
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1600080101Y00000X
OHOH3252984101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool