Provider Demographics
NPI:1982988184
Name:DANIELS, SUSAN (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CRESCENT VISCHER FERRY RD APT 517
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-7942
Mailing Address - Country:US
Mailing Address - Phone:518-371-2412
Mailing Address - Fax:
Practice Address - Street 1:100 ELBEL COURT
Practice Address - Street 2:MYERS MIDDLE SCHOOL
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209
Practice Address - Country:US
Practice Address - Phone:518-475-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730463531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical