Provider Demographics
NPI:1588326276
Name:LACOSS, DANIELLE ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ROSE
Last Name:LACOSS
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 1:3323 HARPETH SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2392
Mailing Address - Country:US
Mailing Address - Phone:269-217-2108
Mailing Address - Fax:
Practice Address - Street 1:3323 HARPETH SPRINGS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2392
Practice Address - Country:US
Practice Address - Phone:269-217-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010983221041C0700X
TN71781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical