Provider Demographics
NPI:1053881953
Name:MCDANIEL, SITRENIA (LISW)
Entity type:Individual
Prefix:MRS
First Name:SITRENIA
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 KNOX ABBOTT DR STE 250
Mailing Address - Street 2:
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-4370
Mailing Address - Country:US
Mailing Address - Phone:803-791-5513
Mailing Address - Fax:803-739-0301
Practice Address - Street 1:440 KNOX ABBOTT DR STE 250
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-4370
Practice Address - Country:US
Practice Address - Phone:803-791-5513
Practice Address - Fax:803-739-0301
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical