Healthcare Provider Details

I. General information

NPI: 1902979677
Provider Name (Legal Business Name): DARNYCE HOUSE HILL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARNYCE A. HOUSE LCSW

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4053 ROCKMILL COVE
ELLENWOOD GA
30294
US

IV. Provider business mailing address

4053 ROCKMILL COVE
ELLENWOOD GA
30294
US

V. Phone/Fax

Practice location:
  • Phone: 404-376-7117
  • Fax: 404-762-9101
Mailing address:
  • Phone: 404-376-7117
  • Fax: 404-376-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number001915
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: