Provider Demographics
NPI:1851742035
Name:ECHOLS, DANITA (LLMSW)
Entity Type:Individual
Prefix:
First Name:DANITA
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 S BEATRICE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48217-1682
Mailing Address - Country:US
Mailing Address - Phone:248-219-2150
Mailing Address - Fax:
Practice Address - Street 1:1513 S BEATRICE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48217-1682
Practice Address - Country:US
Practice Address - Phone:248-219-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801096852104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker