Provider Demographics
NPI:1528384963
Name:WALLEN, DARCY FRANCES (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DARCY
Middle Name:FRANCES
Last Name:WALLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:RUS
Other - Middle Name:DEVORAH
Other - Last Name:WALLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:95 FOXCROFT LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3203
Mailing Address - Country:US
Mailing Address - Phone:716-626-6703
Mailing Address - Fax:
Practice Address - Street 1:95 FOXCROFT LN
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3203
Practice Address - Country:US
Practice Address - Phone:716-626-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073886-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical