Provider Demographics
NPI:1003179094
Name:MARSHALL, DANELLE W (LCSW)
Entity type:Individual
Prefix:MS
First Name:DANELLE
Middle Name:W
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DANELLE
Other - Middle Name:W
Other - Last Name:NEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:707 BROADWAY BLVD NE STE 500
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2367
Mailing Address - Country:US
Mailing Address - Phone:505-268-0701
Mailing Address - Fax:270-689-6677
Practice Address - Street 1:707 BROADWAY BLVD NE STE 500
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2367
Practice Address - Country:US
Practice Address - Phone:505-268-0701
Practice Address - Fax:270-689-6677
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-136351041C0700X
NMC-111091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical