Healthcare Provider Details

I. General information

NPI: 1235116930
Provider Name (Legal Business Name): DARLENE PAPA JORDAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARLENE DOMENICA PAPA LCSW

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SHALLCROSS AVE STE 2
WILMINGTON DE
19806-3037
US

IV. Provider business mailing address

1500 SHALLCROSS AVE STE 2
WILMINGTON DE
19806-3037
US

V. Phone/Fax

Practice location:
  • Phone: 302-743-2984
  • Fax: 302-326-0664
Mailing address:
  • Phone: 302-743-2984
  • Fax: 302-326-0664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberQ1-0000749
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: