Provider Demographics
NPI:1740569714
Name:KUDELA, DANIELLE C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:C
Last Name:KUDELA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:C
Other - Last Name:DEMUNDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4061 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14174-9609
Mailing Address - Country:US
Mailing Address - Phone:716-754-8281
Mailing Address - Fax:716-286-7876
Practice Address - Street 1:4061 CREEK RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:NY
Practice Address - Zip Code:14174-9609
Practice Address - Country:US
Practice Address - Phone:716-754-8281
Practice Address - Fax:716-286-7876
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00083453104100000X
NY000817661041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker