Provider Demographics
NPI:1396393583
Name:FEREBEE, DANIELLE TAWANDA (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:TAWANDA
Last Name:FEREBEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 N ROAD ST SUITE E #23
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-6816
Mailing Address - Country:US
Mailing Address - Phone:252-516-4126
Mailing Address - Fax:252-359-4821
Practice Address - Street 1:1313 N ROAD ST SUITE E #23
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6816
Practice Address - Country:US
Practice Address - Phone:252-516-4126
Practice Address - Fax:252-359-4821
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0143031041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical