Healthcare Provider Details

I. General information

NPI: 1063789451
Provider Name (Legal Business Name): DARLYS E. WILLER, LSCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 E IRON AVE SUITE D
SALINA KS
67401-2697
US

IV. Provider business mailing address

645 E IRON AVE SUITE D
SALINA KS
67401-2697
US

V. Phone/Fax

Practice location:
  • Phone: 785-827-2600
  • Fax: 785-309-0184
Mailing address:
  • Phone: 785-827-2600
  • Fax: 785-309-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number664
License Number StateKS

VIII. Authorized Official

Name: MS. DARLYS E WILLER
Title or Position: OWNER
Credential: LSCSW
Phone: 785-827-2700