Provider Demographics
NPI:1568502342
Name:DARVELL, NIGEL B (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:B
Last Name:DARVELL
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 334
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6857
Mailing Address - Country:US
Mailing Address - Phone:314-989-0542
Mailing Address - Fax:314-989-0559
Practice Address - Street 1:522 N NEW BALLAS RD
Practice Address - Street 2:SUITE 334
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6857
Practice Address - Country:US
Practice Address - Phone:314-989-0542
Practice Address - Fax:314-989-0559
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0021961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO237657OtherHEALTHLINK
MO499673119Medicaid
MO091244000OtherMAGELLAN
MO152093OtherBLUE CROSS BLUE SHIELD
MO6212559OtherUNITED BEHAVIORAL HEALTH
MO275778OtherVALUE OPTIONS ID
MOO64006OtherEXCLUSIVE CHOICE
MO430985159DAROtherMERCY HEALTH PLANS
MO43098515902OtherCMR UNITY
MO000077644Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
MO275778OtherVALUE OPTIONS ID