Provider Demographics
NPI:1043490808
Name:RELYEA, DANIELLE DOLORES (LMSW)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:DOLORES
Last Name:RELYEA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1735
Mailing Address - Country:US
Mailing Address - Phone:631-334-6270
Mailing Address - Fax:
Practice Address - Street 1:900 ROUTE 111
Practice Address - Street 2:SUITE 210
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-334-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068753-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker