Provider Demographics
NPI:1043420961
Name:CLARKE, DARCY SULLIVAN (LPCC, CADC-II)
Entity Type:Individual
Prefix:MR
First Name:DARCY
Middle Name:SULLIVAN
Last Name:CLARKE
Suffix:
Gender:M
Credentials:LPCC, CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 PINE GARDEN LN
Mailing Address - Street 2:#D
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5512
Mailing Address - Country:US
Mailing Address - Phone:916-692-5947
Mailing Address - Fax:
Practice Address - Street 1:506 PINE GARDEN LN
Practice Address - Street 2:#D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5512
Practice Address - Country:US
Practice Address - Phone:916-692-5947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional