Provider Demographics
NPI:1023866233
Name:ANDREWS, DANIELLE SHAN IS (LMSW, MPH)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SHAN IS
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LMSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S COTTAGE ST APT 205
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6357
Mailing Address - Country:US
Mailing Address - Phone:516-732-6781
Mailing Address - Fax:
Practice Address - Street 1:125 S COTTAGE ST APT 205
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6357
Practice Address - Country:US
Practice Address - Phone:516-732-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119334101YA0400X, 101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health