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NPI Code Detail

MEDICARE: DANIELLE ANTOINETTE DEST LCSW

MEDICARE: DANIELLE ANTOINETTE DEST LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC011178NC

General Provider Information

NPI Number : 1134659535
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE ANTOINETTE DEST LCSW
Provider Business Mailing Address
First Line : PO BOX 936857
Second Line :
City : ATLANTA
State : GA
Zip : 31193-6857
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-7787
Fax Number : 910-815-5850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 01/12/2026

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Directions to “ DANIELLE ANTOINETTE DEST LCSW” Practice Location

Language Start Address Practice Location
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