Provider Demographics
NPI:1700205671
Name:COLEMAN, DANIELLE SHAWNTEA (LCSW, DAAC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SHAWNTEA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW, DAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6008 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-2553
Mailing Address - Country:US
Mailing Address - Phone:916-706-1822
Mailing Address - Fax:
Practice Address - Street 1:6008 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-2553
Practice Address - Country:US
Practice Address - Phone:916-706-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker