Provider Demographics
NPI:1689852725
Name:DANIELS, ELAINE (LCSW)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5707 N 22ND STREET
Mailing Address - Street 2:MENTAL HEALTH CARE INC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-4350
Mailing Address - Country:US
Mailing Address - Phone:813-239-8069
Mailing Address - Fax:813-272-3766
Practice Address - Street 1:5707 N 22ND STREET
Practice Address - Street 2:MENTAL HEALTH CARE INC
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4350
Practice Address - Country:US
Practice Address - Phone:813-239-8069
Practice Address - Fax:813-272-3766
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW47541041C0700X
FLSW97821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical