Provider Demographics
NPI:1952633489
Name:SHOLCOSKY, DANIELLE DIONNE (LCSW/CPRP)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:DIONNE
Last Name:SHOLCOSKY
Suffix:
Gender:F
Credentials:LCSW/CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30-32 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-2304
Mailing Address - Country:US
Mailing Address - Phone:570-282-1732
Mailing Address - Fax:570-282-6805
Practice Address - Street 1:30-32 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2304
Practice Address - Country:US
Practice Address - Phone:570-282-1732
Practice Address - Fax:570-282-6805
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW 127249104100000X
PACW0174221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical