Provider Demographics
NPI:1265000988
Name:CLINE, DARYL SCOTT (MSW, CDP)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:SCOTT
Last Name:CLINE
Suffix:
Gender:M
Credentials:MSW, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W EMMA AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2531
Mailing Address - Country:US
Mailing Address - Phone:208-665-1707
Mailing Address - Fax:208-667-8649
Practice Address - Street 1:915 W EMMA AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2531
Practice Address - Country:US
Practice Address - Phone:208-665-1707
Practice Address - Fax:208-667-8649
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60416722101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)