Provider Demographics
NPI:1346216520
Name:DARNELL, JOLEE N (PHD, LICSW)
Entity Type:Individual
Prefix:DR
First Name:JOLEE
Middle Name:N
Last Name:DARNELL
Suffix:
Gender:F
Credentials:PHD, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 SHADY LN SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-3461
Mailing Address - Country:US
Mailing Address - Phone:253-477-3771
Mailing Address - Fax:253-967-1199
Practice Address - Street 1:2008 N 3RD AVE
Practice Address - Street 2:IMLM HRS
Practice Address - City:FORT LEWIS
Practice Address - State:WA
Practice Address - Zip Code:98433
Practice Address - Country:US
Practice Address - Phone:253-477-3771
Practice Address - Fax:253-967-1199
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000051701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical