Provider Demographics
NPI:1699229211
Name:SULLIVAN, DANIELLE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MACGILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:2201 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2727
Mailing Address - Country:US
Mailing Address - Phone:724-981-7141
Mailing Address - Fax:724-981-7763
Practice Address - Street 1:2201 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2727
Practice Address - Country:US
Practice Address - Phone:724-981-7141
Practice Address - Fax:724-981-7763
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133080104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker