Provider Demographics
NPI:1023055670
Name:UNDERWOOD, DANELL (LSCSW)
Entity type:Individual
Prefix:
First Name:DANELL
Middle Name:
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 SW 12TH ST APT 15
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612-1777
Mailing Address - Country:US
Mailing Address - Phone:316-535-1143
Mailing Address - Fax:
Practice Address - Street 1:806 SW 12TH ST APT 15
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1777
Practice Address - Country:US
Practice Address - Phone:316-535-1143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS070682OtherBLUE CROSS BLUE SHIELD
KS8984OtherPREFERRED HEALTH SYSTEMS
KS070682OtherBLUE CROSS BLUE SHIELD