Provider Demographics
NPI:1841498854
Name:DANLEY, KATHERINE HALLER (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:HALLER
Last Name:DANLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:HALLER
Other - Last Name:DANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1228 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993
Mailing Address - Country:US
Mailing Address - Phone:217-721-3286
Mailing Address - Fax:
Practice Address - Street 1:1228 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-3399
Practice Address - Country:US
Practice Address - Phone:217-721-3286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW172431041C0700X
IN34007513A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34007513OtherSOCIAL WORKER
IN1841498854OtherSOCIAL WORKER