Provider Demographics
NPI:1447945779
Name:LEYVA, DANIELLE MARIE (LPC-A)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:LEYVA
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:GRANILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3005 S LAMAR BLVD STE 109D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4785
Mailing Address - Country:US
Mailing Address - Phone:512-351-3113
Mailing Address - Fax:512-887-3970
Practice Address - Street 1:1221 W BEN WHITE BLVD STE 210A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7182
Practice Address - Country:US
Practice Address - Phone:512-960-4533
Practice Address - Fax:512-887-3970
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health