Provider Demographics
NPI:1710271622
Name:MCDANIEL, LAWRENCE M (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:MCDANIEL
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 1:4200 FAUROT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0372
Mailing Address - Country:US
Mailing Address - Phone:573-819-6701
Mailing Address - Fax:
Practice Address - Street 1:9501 W COYOTE HILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:MO
Practice Address - Zip Code:65256-9598
Practice Address - Country:US
Practice Address - Phone:573-874-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110151951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical