Provider Demographics
NPI:1295522506
Name:DANIELLE MADONNA LCSW SERVICE PLLC
Entity type:Organization
Organization Name:DANIELLE MADONNA LCSW SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-313-4669
Mailing Address - Street 1:70 CALIFORNIA PL S
Mailing Address - Street 2:
Mailing Address - City:ISLAND PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11558-2201
Mailing Address - Country:US
Mailing Address - Phone:516-313-4669
Mailing Address - Fax:
Practice Address - Street 1:70 CALIFORNIA PL S
Practice Address - Street 2:
Practice Address - City:ISLAND PARK
Practice Address - State:NY
Practice Address - Zip Code:11558-2201
Practice Address - Country:US
Practice Address - Phone:516-313-4669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty