Provider Demographics
NPI:1548870702
Name:MCDANIEL, JANET (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:WATTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:48 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WV
Mailing Address - Zip Code:26354-7131
Mailing Address - Country:US
Mailing Address - Phone:304-694-6539
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-1283
Practice Address - Country:US
Practice Address - Phone:304-265-0400
Practice Address - Fax:304-265-5339
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
WV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)