MEDICARE: MR. DARRIN LEE MCNEILL MSW,LCSWA,LCASA

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	1041C0700X	Clinical Social Worker	P-010554	NC

General Provider Information

NPI Number	:	1962913673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARRIN LEE MCNEILL MSW,LCSWA,LCASA

Provider Business Mailing Address
First Line	:	3508 TREE RING CT
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-7465
Country	:	US
Telephone Number	:	910-583-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 S STEWART ST
Second Line	:
City	:	RAEFORD
State	:	NC
Zip	:	28376-3329
Country	:	US
Telephone Number	:	910-904-7147
Fax Number	:	910-904-7148

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

Provider Enumeration Date	:	10/20/2017
Last Update Date	:	10/20/2017

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