Provider Demographics
NPI:1477278620
Name:EDMONDS, DARAN (LCSW)
Entity Type:Individual
Prefix:
First Name:DARAN
Middle Name:
Last Name:EDMONDS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N GREENSBORO ST APT 41
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1776
Mailing Address - Country:US
Mailing Address - Phone:919-230-0807
Mailing Address - Fax:
Practice Address - Street 1:506 N GREENSBORO ST APT 41
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1776
Practice Address - Country:US
Practice Address - Phone:919-230-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0155211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical