Provider Demographics
NPI:1962398321
Name:FOSTER, DANIELLE BRANNOCK (LCSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:BRANNOCK
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-1726
Mailing Address - Country:US
Mailing Address - Phone:850-556-8091
Mailing Address - Fax:
Practice Address - Street 1:1497 MARKET ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-1726
Practice Address - Country:US
Practice Address - Phone:850-556-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW22347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health