Provider Demographics
NPI:1467839019
Name:D'ARCO, CHRIS MORGAN
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:MORGAN
Last Name:D'ARCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:N
Other - Last Name:DARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 51ST ST E APT 1404B
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-8524
Mailing Address - Country:US
Mailing Address - Phone:180-172-6449
Mailing Address - Fax:
Practice Address - Street 1:702 51ST ST E APT 1404B
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-8524
Practice Address - Country:US
Practice Address - Phone:180-172-6449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
FLRBT-19-89486106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1043243140Medicaid
FL110449600Medicaid