Provider Demographics
NPI:1013576305
Name:STEVENS ROANE, DANIELLE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:M
Last Name:STEVENS ROANE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:M
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1909 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7776
Mailing Address - Country:US
Mailing Address - Phone:216-798-4473
Mailing Address - Fax:
Practice Address - Street 1:326 MORGAN ST
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-3077
Practice Address - Country:US
Practice Address - Phone:254-953-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX616551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical