Provider Demographics
NPI:1851830251
Name:DANIEL, JAMIE (LBSW)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 RS COUNTY ROAD 2440
Mailing Address - Street 2:
Mailing Address - City:ALBA
Mailing Address - State:TX
Mailing Address - Zip Code:75410
Mailing Address - Country:US
Mailing Address - Phone:214-535-4874
Mailing Address - Fax:
Practice Address - Street 1:2716 LEE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-4176
Practice Address - Country:US
Practice Address - Phone:214-535-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63928104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker