Provider Demographics
NPI:1497465900
Name:DARIN, ALISSA K (LPC)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:K
Last Name:DARIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 DAIRY AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-2679
Mailing Address - Country:US
Mailing Address - Phone:262-337-9770
Mailing Address - Fax:
Practice Address - Street 1:383 WILLIAMSTOWNE STE 101
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2332
Practice Address - Country:US
Practice Address - Phone:262-337-9770
Practice Address - Fax:262-337-9771
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10111-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10111-125OtherSTATE LICENSE
WI10111-125OtherLICENSE