Provider Demographics
NPI:1821458696
Name:MRVELJ, DARLENE J (LICDC/CS)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:J
Last Name:MRVELJ
Suffix:
Gender:F
Credentials:LICDC/CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WESTCHESTER DR STE 1
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3963
Mailing Address - Country:US
Mailing Address - Phone:330-270-3660
Mailing Address - Fax:330-953-3691
Practice Address - Street 1:100 WESTCHESTER DR STE 1
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3963
Practice Address - Country:US
Practice Address - Phone:330-270-3660
Practice Address - Fax:330-953-3691
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH91481101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)