Provider Demographics
NPI:1346758505
Name:KELLEY, DANIELLE N (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:N
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE., ML 3014
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4788
Mailing Address - Fax:513-636-4283
Practice Address - Street 1:3333 BURNET AVE., ML 3014
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4788
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2002403104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker