MEDICARE: MRS. ELIZABETH ELAINE DANIELS LISW-CP, 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	C013828	NC
2	1041C0700X	Clinical Social Worker	14827	SC

General Provider Information

NPI Number	:	1225610728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH ELAINE DANIELS LISW-CP, LCSW

Provider Business Mailing Address
First Line	:	107 HULTON LN
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29485-3496
Country	:	US
Telephone Number	:	828-244-7957
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 W 4TH NORTH ST
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-6550
Country	:	US
Telephone Number	:	843-501-1099
Fax Number	:

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

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	08/16/2022

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