Provider Demographics
NPI:1265236962
Name:MATTEUCCI, DANIELLE RODGERS (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RODGERS
Last Name:MATTEUCCI
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W KALER DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7244
Mailing Address - Country:US
Mailing Address - Phone:602-315-4127
Mailing Address - Fax:
Practice Address - Street 1:525 W KALER DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7244
Practice Address - Country:US
Practice Address - Phone:602-315-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ190581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical