Provider Demographics
NPI:1013712397
Name:KYRILLOS, DANNIELLE
Entity type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:
Last Name:KYRILLOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-3654
Mailing Address - Country:US
Mailing Address - Phone:917-447-7230
Mailing Address - Fax:
Practice Address - Street 1:23A HOSPITAL ST.
Practice Address - Street 2:NUMBER 2
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-1001
Practice Address - Country:US
Practice Address - Phone:833-409-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2-67445-2B104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker