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NPI 1235337445

NPI 1235337445 : KELVIN S DARR LPC, LADAC : TYLER, TX

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General NPI Number Information
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    NPI Number           |    1235337445
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    Entity Type          |    Individual 
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    Provider Name        |    KELVIN S DARR LPC, LADAC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/10/2007
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    Last Update Date     |    05/13/2025
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Provider Practice Location Address
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    Address Line         |    523 S FANNIN AVE 
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    City                 |    TYLER
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    State                |    TX
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    Zip                  |    75702-8204
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    Country              |    US
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    Telephone            |    903-535-9041
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    Fax                  |    903-630-2039
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Provider Business Mailing Address
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    Address Line         |    523 S FANNIN AVE 
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    City                 |    TYLER
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    State                |    TX
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    Zip                  |    75702-8204
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    Country              |    US
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    Telephone            |    903-535-9041
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    317L
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    License Number State |    AR
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    P1206071
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    License Number State |    AR
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Taxonomy #3
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    63847
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    License Number State |    TX
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