Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eben Blake Danielson

Individual provider Professional Counselor · NPI 1437662970

Eben Blake Danielson is a Mental Health Counselor in Moorhead, Minnesota. Qualified in 2015, 11 years ago. Licensed in Minnesota.

Years since qualifying
11
Licensed in
MN
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

815 37th Ave S
Moorhead, MN 56560-5524
Phone: (701) 451-4811
Fax: (651) 925-0057
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence CC01693 (MN)
Professional Counselor Taxonomy 101YP2500X · Licence 01905 (MN)

Record details

NPI number1437662970
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 7, 2017
Last updated in NPPESFebruary 25, 2020
Certification dateFebruary 25, 2020
Mailing address1201 25th St S, Fargo, ND 58103-2311

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Moorhead