Provider Demographics
NPI:1114032588
Name:STRUBLE, DANIEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:STRUBLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1533
Mailing Address - Country:US
Mailing Address - Phone:732-335-1675
Mailing Address - Fax:732-335-1151
Practice Address - Street 1:32 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1533
Practice Address - Country:US
Practice Address - Phone:732-335-1675
Practice Address - Fax:732-335-1151
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00113700101YA0400X
NJ44SC052238001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical