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NPI Code Detail

MEDICARE: MR. DANIEL DENOOYER LMSW

MEDICARE: MR. DANIEL DENOOYER LMSW
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 Worker6801090821MI

General Provider Information

NPI Number : 1932509726
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL DENOOYER LMSW
Provider Business Mailing Address
First Line : PO BOX 776974
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6974
Country : US
Telephone Number : 231-672-2119
Fax Number : 313-432-7759
Provider Business Practice Location Address
First Line : 1175 WILSON AVE NW
Second Line :
City : WALKER
State : MI
Zip : 49534-6407
Country : US
Telephone Number : 616-685-8650
Fax Number : 616-791-2160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2014
Last Update Date : 08/19/2022

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