Provider Demographics
NPI:1710863006
Name:BOUSQUET, DANIELLE (LMSW, CAC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BOUSQUET
Suffix:
Gender:F
Credentials:LMSW, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BROAD ST UNIT C-4
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4750
Mailing Address - Country:US
Mailing Address - Phone:203-212-9171
Mailing Address - Fax:
Practice Address - Street 1:203 BROAD ST UNIT C-4
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4750
Practice Address - Country:US
Practice Address - Phone:203-212-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11373104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker