Provider Demographics
NPI:1568940930
Name:DARCY DONNELLY PHD PC
Entity Type:Organization
Organization Name:DARCY DONNELLY PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-520-3155
Mailing Address - Street 1:39520 WOODWARD AVE STE 233
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5059
Mailing Address - Country:US
Mailing Address - Phone:248-520-3155
Mailing Address - Fax:248-779-7108
Practice Address - Street 1:39520 WOODWARD AVE STE 233
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5059
Practice Address - Country:US
Practice Address - Phone:248-520-3155
Practice Address - Fax:248-779-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty