Provider Demographics
NPI:1952001554
Name:STEFAN, DANIELLE RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENEE
Last Name:STEFAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10207 CHASE COMMONS DR APT 308
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4670
Mailing Address - Country:US
Mailing Address - Phone:303-564-9418
Mailing Address - Fax:
Practice Address - Street 1:10207 CHASE COMMONS DR APT 308
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4670
Practice Address - Country:US
Practice Address - Phone:303-564-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040148191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty