Provider Demographics
NPI:1245749803
Name:WLADYSZEWSKI, DANIELLE M (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:M
Last Name:WLADYSZEWSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:M
Other - Last Name:ZINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:DEPARTMENT OF CLINICAL SOCIAL WORK
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-4509
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:DEPARTMENT OF CLINICAL SOCIAL WORK
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4509
Practice Address - Fax:401-444-5715
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW031611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical