Provider Demographics
NPI:1114596012
Name:DOWNEY, DANIEL BOYLE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BOYLE
Last Name:DOWNEY
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 1:4950 KEMPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1129
Mailing Address - Country:US
Mailing Address - Phone:314-448-1834
Mailing Address - Fax:
Practice Address - Street 1:4950 KEMPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1129
Practice Address - Country:US
Practice Address - Phone:314-448-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210203721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical