Provider Demographics
NPI:1487044327
Name:STAPLETON, DANECE R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANECE
Middle Name:R
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DANECE
Other - Middle Name:RENEE
Other - Last Name:MOYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:372 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2261
Mailing Address - Country:US
Mailing Address - Phone:909-289-5250
Mailing Address - Fax:201-353-8530
Practice Address - Street 1:372 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2261
Practice Address - Country:US
Practice Address - Phone:909-289-5250
Practice Address - Fax:201-353-8530
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health