Provider Demographics
NPI:1306516638
Name:KLETT, DANIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KLETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 FISHING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-1683
Mailing Address - Country:US
Mailing Address - Phone:480-688-3472
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 21
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-0021
Practice Address - Country:US
Practice Address - Phone:912-434-7125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ177261041C0700X
IL1490167931041C0700X
SC170191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical