Provider Demographics
NPI:1033527023
Name:BLYMYER, DANIELLE (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BLYMYER
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 SCHAUB DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1862
Mailing Address - Country:US
Mailing Address - Phone:301-775-8036
Mailing Address - Fax:
Practice Address - Street 1:1011 SCHAUB DR
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1862
Practice Address - Country:US
Practice Address - Phone:301-775-8036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPOO88371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical