Provider Demographics
NPI:1386655827
Name:DANIELS, NANCY LEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LEE
Last Name:DANIELS
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 1:413 NORTH ATLANTIC STREET
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706
Mailing Address - Country:US
Mailing Address - Phone:208-631-9169
Mailing Address - Fax:
Practice Address - Street 1:500 WEST FORT STREET
Practice Address - Street 2:BOISE VETERANS AFFAIRS MEDICAL CENTER (531/122)
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:208-422-1360
Practice Address - Fax:208-422-1323
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-25203104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker