Provider Demographics
NPI:1073763363
Name:DANIELS, CANDACE LYNNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:LYNNE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51424 VAN DYKE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SHELBY TWP.
Mailing Address - State:MI
Mailing Address - Zip Code:48316
Mailing Address - Country:US
Mailing Address - Phone:586-731-7808
Mailing Address - Fax:
Practice Address - Street 1:51424 VAN DYKE
Practice Address - Street 2:SUITE 8.
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316
Practice Address - Country:US
Practice Address - Phone:586-731-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010813031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical