Individual
MS. LYSSA MICHELLE DANEHY
Active
Individual
MS. LYSSA MICHELLE DANEHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-4133
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20278400987107A001
TRICARE
NM
01
—
22051
HSN CREDENTIALLING & VERI
NM
05
—
68338287
—
NM
01
—
95266
LOVELACE HEALTH PLAN
NM
05
—
NM202639
—
NM
Enumeration date
02/12/2006
Last updated
01/04/2008
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