Provider Demographics
NPI:1619090248
Name:DARST, HAROLD CLIFFORD (CADC II)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:CLIFFORD
Last Name:DARST
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-5240
Mailing Address - Country:US
Mailing Address - Phone:541-954-7077
Mailing Address - Fax:888-505-1903
Practice Address - Street 1:344 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4814
Practice Address - Country:US
Practice Address - Phone:541-954-7077
Practice Address - Fax:888-505-1903
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2015-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR99-11-61101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)