Provider Demographics
NPI:1316364326
Name:KENNEY, DANIELLE (LICSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 OLD FARM RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3739
Mailing Address - Country:US
Mailing Address - Phone:617-918-3546
Mailing Address - Fax:617-322-1522
Practice Address - Street 1:181 OLD FARM RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3739
Practice Address - Country:US
Practice Address - Phone:617-918-3546
Practice Address - Fax:617-322-1522
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1165201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical