Provider Demographics
NPI:1659548212
Name:ALLEN, DARRYL VINCENT (LPC)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:VINCENT
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28231 PEPPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-5649
Mailing Address - Country:US
Mailing Address - Phone:313-207-6347
Mailing Address - Fax:
Practice Address - Street 1:13701 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2080
Practice Address - Country:US
Practice Address - Phone:248-398-0199
Practice Address - Fax:248-398-0299
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-00372101YA0400X
MI6401008657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)