Provider Demographics
NPI:1750463840
Name:IVEY, DARRELL KEITH (MSW, LMHC, CEAP, SAP)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:KEITH
Last Name:IVEY
Suffix:
Gender:M
Credentials:MSW, LMHC, CEAP, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 OFFICE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2807
Mailing Address - Country:US
Mailing Address - Phone:850-942-6000
Mailing Address - Fax:
Practice Address - Street 1:207 OFFICE PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2807
Practice Address - Country:US
Practice Address - Phone:850-942-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 1824101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2349OtherBCBS