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NPI Code Detail

MEDICARE: DARREN E. NORDIN LICSW

MEDICARE: DARREN E. NORDIN LICSW
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 Worker110459MA

General Provider Information

NPI Number : 1558465187
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARREN E. NORDIN LICSW
Provider Business Mailing Address
First Line : 391 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2119
Country : US
Telephone Number : 978-322-5120
Fax Number :
Provider Business Practice Location Address
First Line : 391 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2119
Country : US
Telephone Number : 978-322-5120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 07/08/2007

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