Provider Demographics
NPI:1467704494
Name:MCDONAUGH, DANIELLE CONSTANCE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CONSTANCE
Last Name:MCDONAUGH
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 1:320 E 94TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5604
Mailing Address - Country:US
Mailing Address - Phone:212-569-2859
Mailing Address - Fax:212-544-7561
Practice Address - Street 1:4600 BROADWAY
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10040-2012
Practice Address - Country:US
Practice Address - Phone:212-569-2859
Practice Address - Fax:212-544-7561
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0876751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical