Healthcare Provider Details

I. General information

NPI: 1689103699
Provider Name (Legal Business Name): JESSICA KATHERINE DANIEL LCSW-C, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 ALEXANDER CHASE APT F
SPARKS GLENCOE MD
21152-9013
US

IV. Provider business mailing address

11307 YORK RD # 320
HUNT VALLEY MD
21030-1962
US

V. Phone/Fax

Practice location:
  • Phone: 240-554-5560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: