Provider Demographics
NPI:1962821025
Name:DANIELS, ELIZABETH (LCSW-A)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BARDEN PL APT C
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-5491
Mailing Address - Country:US
Mailing Address - Phone:347-794-1830
Mailing Address - Fax:888-421-1169
Practice Address - Street 1:22 BARDEN PL APT C
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5491
Practice Address - Country:US
Practice Address - Phone:347-794-1830
Practice Address - Fax:888-421-1169
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0085651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical