Healthcare Provider Details

I. General information

NPI: 1164560132
Provider Name (Legal Business Name): DARLENE NICHOLE ROHN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARLENE NICHOLE SALMONS LCSW

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PFEIFFER AVE
KIRKSVILLE MO
63501-5047
US

IV. Provider business mailing address

105 PFEIFFER AVE
KIRKSVILLE MO
63501-5047
US

V. Phone/Fax

Practice location:
  • Phone: 660-665-4612
  • Fax: 660-665-4635
Mailing address:
  • Phone: 660-665-4612
  • Fax: 660-665-4635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: