Provider Demographics
NPI:1447595210
Name:DANIELI, INNA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:DANIELI
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 1:169 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2228
Mailing Address - Country:US
Mailing Address - Phone:917-363-6302
Mailing Address - Fax:
Practice Address - Street 1:1182 TEANECK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4824
Practice Address - Country:US
Practice Address - Phone:917-363-6302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055278001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical