Provider Demographics
NPI:1629392907
Name:MCQUILLAR, DANIELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:MCQUILLAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1312
Mailing Address - Country:US
Mailing Address - Phone:860-229-8887
Mailing Address - Fax:860-229-8886
Practice Address - Street 1:92 VINE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1433
Practice Address - Country:US
Practice Address - Phone:860-223-9291
Practice Address - Fax:860-223-3111
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0071841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical