Provider Demographics
NPI:1568773240
Name:KOEPER, DANAE SUSAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DANAE
Middle Name:SUSAN
Last Name:KOEPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DANAE
Other - Middle Name:SUSAN
Other - Last Name:PUFTA-O'LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3806 GULF OF MEXICO DR
Mailing Address - Street 2:UNIT C-109
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-2738
Mailing Address - Country:US
Mailing Address - Phone:941-879-2970
Mailing Address - Fax:941-244-5505
Practice Address - Street 1:3806 GULF OF MEXICO DR
Practice Address - Street 2:UNIT C-109
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-2738
Practice Address - Country:US
Practice Address - Phone:941-879-2970
Practice Address - Fax:941-244-5505
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 76871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical