Provider Demographics
NPI:1699505461
Name:DARNELL, DEON LAVELLE (CSAC, CADC)
Entity type:Individual
Prefix:
First Name:DEON
Middle Name:LAVELLE
Last Name:DARNELL
Suffix:
Gender:M
Credentials:CSAC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 FOREHAND DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2006
Mailing Address - Country:US
Mailing Address - Phone:757-861-9020
Mailing Address - Fax:
Practice Address - Street 1:2856 FOREHAND DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2006
Practice Address - Country:US
Practice Address - Phone:757-861-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013730103TA0400X
VA0710102886101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)