Provider Demographics
NPI:1679296669
Name:DARBY, GEORGE W III
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:DARBY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 GOOSE NECK LN
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4868
Mailing Address - Country:US
Mailing Address - Phone:215-200-9150
Mailing Address - Fax:
Practice Address - Street 1:7 FARMHOUSE RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-1613
Practice Address - Country:US
Practice Address - Phone:215-200-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health