Provider Demographics
NPI:1821642885
Name:DANIELS, KALYN NICOLE (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:KALYN
Middle Name:NICOLE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 HIGH HOUSE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8496
Mailing Address - Country:US
Mailing Address - Phone:919-678-0124
Mailing Address - Fax:
Practice Address - Street 1:206 HIGH HOUSE RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8496
Practice Address - Country:US
Practice Address - Phone:919-678-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0139421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical