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General NPI Number Information
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NPI Number | 1174357909
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Entity Type | Organization
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Legal Business Name | DANIELLE KLETT LCSW LLC
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Dates
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Enumeration Date | 08/26/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1305 FISHING CREEK RD
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City | CLOVER
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State | SC
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Zip | 29710-1683
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Country | US
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Telephone | 480-688-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 FISHING CREEK RD
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City | CLOVER
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State | SC
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Zip | 29710-1683
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Country | US
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Telephone | 480-688-3472
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DANIELLE KLETT
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Credential | LCSW
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Telephone | 912-434-7125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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