Provider Demographics
NPI:1831669662
Name:DANENBERG, LORI SUE (LCSW)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:SUE
Last Name:DANENBERG
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 1:30 GLENN ST STE 207
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3252
Mailing Address - Country:US
Mailing Address - Phone:914-390-0220
Mailing Address - Fax:
Practice Address - Street 1:30 GLENN ST STE 207
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3252
Practice Address - Country:US
Practice Address - Phone:914-390-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0382211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR-038221OtherNYS LICENSE