Provider Demographics
NPI:1154018646
Name:CZAJKOWSKI, DANIELLE (LMSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:CZAJKOWSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6023 71ST AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5187
Mailing Address - Country:US
Mailing Address - Phone:727-423-4248
Mailing Address - Fax:
Practice Address - Street 1:2190 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1307
Practice Address - Country:US
Practice Address - Phone:727-423-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP2701X
NY119017104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy