Provider Demographics
NPI:1861712283
Name:ESTOPINAL, DANIEL JULES (LCSW)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JULES
Last Name:ESTOPINAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 RAINBOW FLS
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-5872
Mailing Address - Country:US
Mailing Address - Phone:762-994-0260
Mailing Address - Fax:
Practice Address - Street 1:210 RAINBOW FLS
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-5872
Practice Address - Country:US
Practice Address - Phone:762-994-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA95001041C0700X
GACSW0048041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical