Provider Demographics
NPI:1104807866
Name:ALDRIDGE, DANIELLE M (LCSW, LSOTP)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:M
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:LCSW, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:501 S CARROLL BLVD BLDG SUITE230
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-7423
Mailing Address - Country:US
Mailing Address - Phone:469-626-7511
Mailing Address - Fax:469-613-0883
Practice Address - Street 1:501 S CARROLL BLVD STE 230
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7423
Practice Address - Country:US
Practice Address - Phone:469-626-7511
Practice Address - Fax:469-613-0883
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99523174400000X
TX241421041C0700X
LA82281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H394CP10Medicare PIN