Provider Demographics
NPI:1871013805
Name:ADAMS, DARREN (LCPC)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10193 W SMOKE RANCH DR APT 102
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6405
Mailing Address - Country:US
Mailing Address - Phone:208-870-0796
Mailing Address - Fax:
Practice Address - Street 1:1612 S COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-3106
Practice Address - Country:US
Practice Address - Phone:208-870-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-8616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional