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General NPI Number Information
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NPI Number | 1295471571
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Entity Type | Organization
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Legal Business Name | DANIELLE NICOLE BURNS, LICENSED CLINICAL SOCIAL WORKER, INCORPORATED
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 1501 SAN ELIJO RD S # 104-310
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City | SAN MARCOS
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State | CA
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Zip | 92078-2047
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Country | US
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Telephone | 619-852-2335
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 SAN ELIJO RD S # 104-310
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City | SAN MARCOS
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State | CA
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Zip | 92078-2047
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Country | US
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Telephone | 619-852-2335
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR, CEO
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Name | DR. DANIELLE NICOLE BURNS
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Credential | PHD, MA, LCSW
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Telephone | 619-852-2335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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