Provider Demographics
NPI:1821443037
Name:DARIN CONWAY, LCSW
Entity Type:Organization
Organization Name:DARIN CONWAY, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:650-336-8033
Mailing Address - Street 1:851 FREMONT AVE
Mailing Address - Street 2:210
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024
Mailing Address - Country:US
Mailing Address - Phone:650-336-8033
Mailing Address - Fax:
Practice Address - Street 1:851 FREMONT AVE
Practice Address - Street 2:210
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024
Practice Address - Country:US
Practice Address - Phone:650-336-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS28759261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health