Provider Demographics
NPI:1114171873
Name:HOUSE, DANIEL GENE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:GENE
Last Name:HOUSE
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2278 VICKY LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8531
Mailing Address - Country:US
Mailing Address - Phone:252-412-0281
Mailing Address - Fax:
Practice Address - Street 1:1705 W 6TH ST
Practice Address - Street 2:BLDG H
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2829
Practice Address - Country:US
Practice Address - Phone:252-758-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical