Healthcare Provider Details

I. General information

NPI: 1588326276
Provider Name (Legal Business Name): DANIELLE ROSE KREULEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE LACOSS LCSW

II. Dates (important events)

Enumeration Date: 10/10/2021
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 CHAMPIONS CIR
FRANKLIN TN
37064-2871
US

IV. Provider business mailing address

3104 CHAMPIONS CIR
FRANKLIN TN
37064-2871
US

V. Phone/Fax

Practice location:
  • Phone: 269-217-2108
  • Fax:
Mailing address:
  • Phone: 269-217-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7178
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: