Provider Demographics
NPI:1730429713
Name:NEBESNI, DANIELLE R (LCSW)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:R
Last Name:NEBESNI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CREST DR
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3231
Mailing Address - Country:US
Mailing Address - Phone:201-390-6186
Mailing Address - Fax:
Practice Address - Street 1:11 CREST DR
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3231
Practice Address - Country:US
Practice Address - Phone:201-390-6186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05834900104100000X
NJ44SC056745001041C0700X
NJ37LC00257900101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)