Provider Demographics
NPI:1467483396
Name:TOWNES, DARRYL LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:LEE
Last Name:TOWNES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2337 DEERFIELD CHASE SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-6307
Mailing Address - Country:US
Mailing Address - Phone:770-880-5332
Mailing Address - Fax:678-420-3488
Practice Address - Street 1:191 PEACHTREE ST
Practice Address - Street 2:SUITE 3300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1740
Practice Address - Country:US
Practice Address - Phone:770-880-5332
Practice Address - Fax:678-420-3488
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002894103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA430278877AMedicaid