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NPI Code Detail

MEDICARE: DARYL A HANDLIN LSCSW

MEDICARE: DARYL A HANDLIN LSCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker4149KS
21041C0700XClinical Social WorkerL7399OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376734426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARYL A HANDLIN LSCSW
Provider Business Mailing Address
First Line : PO BOX 100
Second Line :
City : ALBANY
State : OR
Zip : 97321-0031
Country : US
Telephone Number : 541-968-3866
Fax Number :
Provider Business Practice Location Address
First Line : 2730 PACIFIC BLVD SE
Second Line :
City : ALBANY
State : OR
Zip : 97321-5075
Country : US
Telephone Number : 541-967-3866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 04/17/2023

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