MEDICARE: ALICIA NICOLE DANLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9871	TN

General Provider Information

NPI Number	:	1194213132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA NICOLE DANLEY LCSW

Provider Business Mailing Address
First Line	:	6029 COLEMAN RD
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-8768
Country	:	US
Telephone Number	:	662-822-7867
Fax Number	:

Provider Business Practice Location Address
First Line	:	6029 COLEMAN RD
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-8768
Country	:	US
Telephone Number	:	662-822-7867
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	01/22/2026

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