Provider Demographics
NPI:1831488865
Name:LA BARRIE, DANIELLE D (LCSW, QS, CAP)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:D
Last Name:LA BARRIE
Suffix:
Gender:F
Credentials:LCSW, QS, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 NE 2ND ST # 122
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3908
Mailing Address - Country:US
Mailing Address - Phone:954-646-8868
Mailing Address - Fax:
Practice Address - Street 1:441 S STATE RD 7 #15
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068
Practice Address - Country:US
Practice Address - Phone:954-646-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11727104100000X, 1041C0700X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060278700Medicaid