Provider Demographics
NPI:1558942169
Name:POE, DARBY LYNN (CRSS)
Entity Type:Individual
Prefix:
First Name:DARBY
Middle Name:LYNN
Last Name:POE
Suffix:
Gender:F
Credentials:CRSS
Other - Prefix:
Other - First Name:DARBY
Other - Middle Name:
Other - Last Name:SEABAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:IL
Mailing Address - Zip Code:61951-1907
Mailing Address - Country:US
Mailing Address - Phone:217-728-4358
Mailing Address - Fax:
Practice Address - Street 1:12 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:IL
Practice Address - Zip Code:61951-1907
Practice Address - Country:US
Practice Address - Phone:217-728-4358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL37466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health