Provider Demographics
NPI:1396124434
Name:KORNACKI, DANIELLE E (MS)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:KORNACKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:E
Other - Last Name:CANTAFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3736
Mailing Address - Country:US
Mailing Address - Phone:413-733-6661
Mailing Address - Fax:413-733-7841
Practice Address - Street 1:176 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-2561
Practice Address - Country:US
Practice Address - Phone:508-980-1604
Practice Address - Fax:508-765-5480
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor