Provider Demographics
NPI:1760508758
Name:ADLER, DANNIELLE ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:ELAINE
Last Name:ADLER
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:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:TAHOE VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:96148-0448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 REGENCY WAY
Practice Address - Street 2:448
Practice Address - City:TAHOE VISTA
Practice Address - State:CA
Practice Address - Zip Code:96148
Practice Address - Country:US
Practice Address - Phone:530-386-6855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0271371041C0700X
NV7485-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical