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General NPI Number Information
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NPI Number | 1588091441
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Entity Type | Organization
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Legal Business Name | DARCIE EVANS LICSW COUNSELING SERVICES
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 67 GOLDFINCH DR
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City | NANTUCKET
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State | MA
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Zip | 02554-6008
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Country | US
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Telephone | 508-825-2552
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Fax | 508-825-0831
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Provider Business Mailing Address
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Address Line | 67 GOLDFINCH DR
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City | NANTUCKET
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State | MA
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Zip | 02554-6008
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Country | US
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Telephone | 508-825-2552
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Fax | 508-825-0831
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DARCIE L EVANS
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Credential | LICSW
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Telephone | 508-825-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 110335
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License Number State | MA
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