Provider Demographics
NPI:1265262141
Name:DALY, ELAINE ELEANOR SR (LMSW)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ELEANOR
Last Name:DALY
Suffix:SR
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OAK ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1709
Mailing Address - Country:US
Mailing Address - Phone:347-722-2135
Mailing Address - Fax:347-274-2820
Practice Address - Street 1:12 OAK ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1709
Practice Address - Country:US
Practice Address - Phone:413-628-1981
Practice Address - Fax:347-274-2820
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121646104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker