Provider Demographics
NPI:1659659134
Name:PORTO, DANIELLE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:M
Last Name:PORTO
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 1:18 PRINCETON ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4006
Mailing Address - Country:US
Mailing Address - Phone:516-727-0780
Mailing Address - Fax:
Practice Address - Street 1:1399 FRANKLIN AVE STE 303
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1678
Practice Address - Country:US
Practice Address - Phone:516-727-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0824281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical