Provider Demographics
NPI:1386971703
Name:KELLY, DARCIE (LCSW)
Entity type:Individual
Prefix:
First Name:DARCIE
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-8115
Mailing Address - Country:US
Mailing Address - Phone:406-558-4743
Mailing Address - Fax:406-204-4518
Practice Address - Street 1:6515 GREEN MEADOW DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-8115
Practice Address - Country:US
Practice Address - Phone:406-558-4743
Practice Address - Fax:406-204-4518
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical