Healthcare Provider Details

I. General information

NPI: 1689636136
Provider Name (Legal Business Name): DANIELLE M. SENECAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MAIN ST
TOPSHAM ME
04086-1221
US

IV. Provider business mailing address

3 ROCKY HILL DR
BRUNSWICK ME
04011-7146
US

V. Phone/Fax

Practice location:
  • Phone: 207-310-0436
  • Fax:
Mailing address:
  • Phone: 207-310-0436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC8050
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: