Provider Demographics
NPI:1205693322
Name:SCOTT, DANIELLE MARIE (LISW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:MCCLUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:2105 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-4822
Mailing Address - Country:US
Mailing Address - Phone:419-210-5095
Mailing Address - Fax:234-218-4939
Practice Address - Street 1:2105 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-4822
Practice Address - Country:US
Practice Address - Phone:419-210-5095
Practice Address - Fax:234-218-4939
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23042071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical