MEDICARE: DANIELLE PAIGE GREENBERG 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	104100000X	Social Worker	1073398	NY
2	1041C0700X	Clinical Social Worker	095074	NY

General Provider Information

NPI Number	:	1306471149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE PAIGE GREENBERG LCSW

Provider Business Mailing Address
First Line	:	72 HERRELS CIR
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-4249
Country	:	US
Telephone Number	:	516-232-3566
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 JERICHO TPKE STE 103
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-1317
Country	:	US
Telephone Number	:	516-232-3566
Fax Number	:

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

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	03/17/2023

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