Provider Demographics
NPI:1841598265
Name:EYERLY, DAISI MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:DAISI
Middle Name:MARIE
Last Name:EYERLY
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 1:1229 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3305
Mailing Address - Country:US
Mailing Address - Phone:814-765-1045
Mailing Address - Fax:814-765-8489
Practice Address - Street 1:1229 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3305
Practice Address - Country:US
Practice Address - Phone:814-765-1045
Practice Address - Fax:814-765-8489
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1253901041C0700X
PACW0172061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical