Provider Demographics
NPI:1740563287
Name:GELLERSEN, DANNY ROY (LICSW)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:ROY
Last Name:GELLERSEN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 3RD AVE STE 423
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1164
Mailing Address - Country:US
Mailing Address - Phone:206-659-6136
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE STE 423
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1164
Practice Address - Country:US
Practice Address - Phone:206-659-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602336741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical