Provider Demographics
NPI:1518720218
Name:DANIELS, STACEY R (MSW)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:R
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-2522
Mailing Address - Country:US
Mailing Address - Phone:304-237-9600
Mailing Address - Fax:
Practice Address - Street 1:213 ROGERS ST
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-2522
Practice Address - Country:US
Practice Address - Phone:304-237-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor