Provider Demographics
NPI:1760542021
Name:ANDERSON, DARREN M (LCSW)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 FAIRVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5493
Mailing Address - Country:US
Mailing Address - Phone:775-684-5000
Mailing Address - Fax:775-687-1181
Practice Address - Street 1:415 HIGHWAY 95A
Practice Address - Street 2:BUILDING I
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9261
Practice Address - Country:US
Practice Address - Phone:775-575-7744
Practice Address - Fax:775-575-7769
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4335-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV102117Medicare PIN