Provider Demographics
NPI:1427307438
Name:TAYLOR, DANIELLE RENEA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RENEA
Last Name:TAYLOR
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 1:3419 VIRGINIA BEACH BLVD # 304
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4419
Mailing Address - Country:US
Mailing Address - Phone:252-260-4117
Mailing Address - Fax:
Practice Address - Street 1:2144 KIMBALL CIR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2558
Practice Address - Country:US
Practice Address - Phone:213-925-6153
Practice Address - Fax:760-631-0778
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040114271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical