Healthcare Provider Details

I. General information

NPI: 1932528759
Provider Name (Legal Business Name): DANIELLE CONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE FIZAZI

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 08/07/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PICCARD DR
ROCKVILLE MD
20850-4320
US

IV. Provider business mailing address

36 SHORT BRANCH DR
RANSON WV
25438-4602
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-4000
  • Fax:
Mailing address:
  • Phone: 301-802-4736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14646
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: