Healthcare Provider Details

I. General information

NPI: 1922524818
Provider Name (Legal Business Name): DANIELLE JEAN WHITTINGTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE JEAN KLENDWORTH LCSW

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19317 SANDY SPRINGS CIR
LUTZ FL
33558-9734
US

IV. Provider business mailing address

19317 SANDY SPRINGS CIR
LUTZ FL
33558-9734
US

V. Phone/Fax

Practice location:
  • Phone: 813-924-9940
  • Fax:
Mailing address:
  • Phone: 813-924-9940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC010075
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: