MEDICARE: DARICE CLAYTON MSSA, LSW

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
1	104100000X	Social Worker	S.2207283	OH

General Provider Information

NPI Number	:	1619483682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARICE CLAYTON MSSA, LSW

Provider Business Mailing Address
First Line	:	1549 ARTMAN AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-7407
Country	:	US
Telephone Number	:	330-957-5553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 E WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3805
Country	:	US
Telephone Number	:	216-932-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2017
Last Update Date	:	01/23/2024

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