Provider Demographics
NPI:1962581843
Name:DANIELS, LAUREN KRISTINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:KRISTINE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:KRISTINE
Other - Last Name:SYNOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:55 WEST MAIN STREET
Mailing Address - Street 2:SUITE 410 WESTERN CONNECTICUT MENTAL HEALTH NETWORK
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702
Mailing Address - Country:US
Mailing Address - Phone:203-805-6408
Mailing Address - Fax:203-805-6432
Practice Address - Street 1:55 WEST MAIN STREET
Practice Address - Street 2:SUITE 410 WESTERN CONNECTICUT MENTAL HEALTH NETWORK
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702
Practice Address - Country:US
Practice Address - Phone:203-805-6408
Practice Address - Fax:203-805-6432
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0048331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
80002663Medicare ID - Type Unspecified