Provider Demographics
NPI:1245676535
Name:TERRILL, DARLENE ANN (LADC)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:ANN
Last Name:TERRILL
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6381 KELL LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-7007
Mailing Address - Country:US
Mailing Address - Phone:702-812-5281
Mailing Address - Fax:
Practice Address - Street 1:5659 DUNCAN DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2811
Practice Address - Country:US
Practice Address - Phone:702-385-2020
Practice Address - Fax:702-658-0480
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00482L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)