Provider Demographics
NPI:1841306453
Name:MICHAUD, DANIEL J (MSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:MICHAUD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BRADLEYS CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12060-3612
Mailing Address - Country:US
Mailing Address - Phone:518-965-2408
Mailing Address - Fax:
Practice Address - Street 1:241 BRADLEYS CROSSING RD
Practice Address - Street 2:
Practice Address - City:EAST CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12060-3612
Practice Address - Country:US
Practice Address - Phone:518-965-2408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0370291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical