Provider Demographics
NPI:1235312414
Name:BENOIT-COUTARD, DANIELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BENOIT-COUTARD
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 1:57 WILLOUGHBY ST
Mailing Address - Street 2:BASEMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5290
Mailing Address - Country:US
Mailing Address - Phone:718-907-6230
Mailing Address - Fax:718-943-6960
Practice Address - Street 1:57 WILLOUGHBY ST
Practice Address - Street 2:BASEMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5290
Practice Address - Country:US
Practice Address - Phone:718-907-6230
Practice Address - Fax:718-943-6960
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0699031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY069903OtherLICENSE