Provider Demographics
NPI:1417650094
Name:NAGEL, DARIAN JUNE (LICSW)
Entity Type:Individual
Prefix:
First Name:DARIAN
Middle Name:JUNE
Last Name:NAGEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21721 519TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:56055-2282
Mailing Address - Country:US
Mailing Address - Phone:507-995-3441
Mailing Address - Fax:
Practice Address - Street 1:21721 519TH AVE
Practice Address - Street 2:
Practice Address - City:LAKE CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:56055-2282
Practice Address - Country:US
Practice Address - Phone:507-995-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN256081041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker