Provider Demographics
NPI:1477886976
Name:PEYSER, DANIEL MCKELVEY (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MCKELVEY
Last Name:PEYSER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 FLYNN AVE
Mailing Address - Street 2:SUITE 3J
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5429
Mailing Address - Country:US
Mailing Address - Phone:802-488-6920
Mailing Address - Fax:
Practice Address - Street 1:75 SAN REMO DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6385
Practice Address - Country:US
Practice Address - Phone:802-488-7350
Practice Address - Fax:802-488-6919
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079624-11041C0700X
VT089-01209961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical