Provider Demographics
NPI:1447850235
Name:MENDELSON, DANIELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:MENDELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:FRYDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1316 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4757
Mailing Address - Country:US
Mailing Address - Phone:847-975-1118
Mailing Address - Fax:
Practice Address - Street 1:3711 N RAVENSWOOD AVE STE 146
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-5944
Practice Address - Country:US
Practice Address - Phone:773-224-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490172281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical