Individual
KEVIN PETERSON DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
156 S STATE ST, DOVER, DE 19901-7314
(302) 470-6661
Mailing address
11 RIPTIDE CT, FREDERICA, DE 19946-2112
(302) 470-6661
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0012323
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q1-0012323
LICENSED CLINICAL SOCIAL WORKER
DE
01
—
Q3-0011163
LICENSED MASTER SOCIAL WORKER
DE
Enumeration date
08/19/2022
Last updated
01/27/2025
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