Provider Demographics
NPI:1194348045
Name:HANEY, DARREN MICHAEL (AAC)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:MICHAEL
Last Name:HANEY
Suffix:
Gender:M
Credentials:AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 NE FOURTH PLAIN BLVD APT 130
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-7210
Mailing Address - Country:US
Mailing Address - Phone:360-984-0172
Mailing Address - Fax:
Practice Address - Street 1:6221 NE FOURTH PLAIN BLVD APT 130
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7210
Practice Address - Country:US
Practice Address - Phone:360-984-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor