Provider Demographics
NPI:1245250026
Name:CHRISTIAN, DANIELLE N (MSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:N
Other - Last Name:DUROCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:47 TOWN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2315
Mailing Address - Country:US
Mailing Address - Phone:860-892-7042
Mailing Address - Fax:860-892-7043
Practice Address - Street 1:47 TOWN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2315
Practice Address - Country:US
Practice Address - Phone:860-892-7042
Practice Address - Fax:860-892-7043
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004264066Medicaid