Provider Demographics
NPI:1134224124
Name:LATIMORE, DANIELLE PATRICE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:PATRICE
Last Name:LATIMORE
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 1:810 VERMONT AVE NW
Mailing Address - Street 2:MAIL CODE 10NC
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20420-0001
Mailing Address - Country:US
Mailing Address - Phone:202-273-9290
Mailing Address - Fax:202-273-6593
Practice Address - Street 1:810 VERMONT AVE NW
Practice Address - Street 2:MAIL CODE 10NC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-0001
Practice Address - Country:US
Practice Address - Phone:202-273-9290
Practice Address - Fax:202-273-6593
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030267051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical