Basic Information
| Provider Information | |||||||||
| NPI: | 1932509726 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DENOOYER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776974 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776974 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2316722119 | ||||||||
| FaxNumber: | 3134327759 | ||||||||
| Practice Location | |||||||||
| Address1: | 1175 WILSON AVE NW | ||||||||
| Address2: | |||||||||
| City: | WALKER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495346407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6166858650 | ||||||||
| FaxNumber: | 6167912160 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2014 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801090821 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.