Provider Demographics
NPI:1396448171
Name:NITKEWICZ, DANIELLE (CMHC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NITKEWICZ
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2442
Mailing Address - Country:US
Mailing Address - Phone:516-238-0681
Mailing Address - Fax:
Practice Address - Street 1:34 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2442
Practice Address - Country:US
Practice Address - Phone:516-238-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health