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NPI Code Detail

MEDICARE: DANIELLE NICOLE WHITEHURST LCSW

MEDICARE: DANIELLE NICOLE WHITEHURST 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1447836622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE NICOLE WHITEHURST LCSW
Provider Business Mailing Address
First Line : 1904 CEDAR ST APT 238
Second Line :
City : RICHMOND
State : VA
Zip : 23223-7499
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8310 MIDLOTHIAN TPKE
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-5163
Country : US
Telephone Number : 757-268-8081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2021
Last Update Date : 03/19/2021

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