Provider Demographics
NPI:1659907830
Name:LOPEZ, DANIELLE M (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:LOPEZ
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 1:24 GRAND TETON DR
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1790
Mailing Address - Country:US
Mailing Address - Phone:302-299-0786
Mailing Address - Fax:
Practice Address - Street 1:2700 SILVERSIDE RD STE 4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3724
Practice Address - Country:US
Practice Address - Phone:302-299-0786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00015421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical