Provider Demographics
NPI:1508112293
Name:NADEAU, DANNY RAY-LEO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:RAY-LEO
Last Name:NADEAU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SMOKE RISE CIR
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-1053
Mailing Address - Country:US
Mailing Address - Phone:508-558-9341
Mailing Address - Fax:
Practice Address - Street 1:73 HUTTLESTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-3156
Practice Address - Country:US
Practice Address - Phone:508-999-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2162781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical