Provider Demographics
NPI:1013953710
Name:DANIEL, DANESA (LCSW)
Entity Type:Individual
Prefix:
First Name:DANESA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 RASOR BLVD
Mailing Address - Street 2:SUITE 259
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0116
Mailing Address - Country:US
Mailing Address - Phone:469-850-2420
Mailing Address - Fax:
Practice Address - Street 1:8105 RASOR BLVD
Practice Address - Street 2:SUITE 259
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0116
Practice Address - Country:US
Practice Address - Phone:469-850-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ47264Medicare UPIN
TXQ47264Medicare UPIN