Provider Demographics
NPI:1902278187
Name:PHILLIPS, DANNY N (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:N
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 PRIMAVERA DR N
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8450
Mailing Address - Country:US
Mailing Address - Phone:310-592-6551
Mailing Address - Fax:
Practice Address - Street 1:1311 PRIMAVERA DR N
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-8450
Practice Address - Country:US
Practice Address - Phone:310-592-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA213731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical