Provider Demographics
NPI:1194500603
Name:KIRBY-MCGANN, DANIELLE ALEXANDRIA (LMSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALEXANDRIA
Last Name:KIRBY-MCGANN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:ALEXANDRIA
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:56 FRANKLIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1281
Mailing Address - Country:US
Mailing Address - Phone:203-709-6141
Mailing Address - Fax:203-709-3215
Practice Address - Street 1:56 FRANKLIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1281
Practice Address - Country:US
Practice Address - Phone:203-709-6141
Practice Address - Fax:203-709-3215
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5726104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker