Provider Demographics
NPI:1528578705
Name:LIGHTELL, DANIEL JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:LIGHTELL
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2601
Mailing Address - Country:US
Mailing Address - Phone:504-214-9055
Mailing Address - Fax:
Practice Address - Street 1:2626 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6400
Practice Address - Country:US
Practice Address - Phone:504-525-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical