Provider Demographics
NPI:1548154438
Name:MENJIVAR MACHUCA, DANIELLA SOFIA (LMSW)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:SOFIA
Last Name:MENJIVAR MACHUCA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:EAST MARION
Mailing Address - State:NY
Mailing Address - Zip Code:11939-1518
Mailing Address - Country:US
Mailing Address - Phone:631-599-6203
Mailing Address - Fax:
Practice Address - Street 1:344 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3923
Practice Address - Country:US
Practice Address - Phone:516-538-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker