Healthcare Provider Details

I. General information

NPI: 1881412880
Provider Name (Legal Business Name): ESI DANIELS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 HERLONG AVE S
ROCK HILL SC
29732-1158
US

IV. Provider business mailing address

222 HERLONG AVE S
ROCK HILL SC
29732-1158
US

V. Phone/Fax

Practice location:
  • Phone: 571-340-1304
  • Fax:
Mailing address:
  • Phone: 571-340-1304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17302
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017335
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: