Provider Demographics
NPI:1669538070
Name:DARROW, MARY S (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:S
Last Name:DARROW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 BROWNSBORO PARK BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1292
Mailing Address - Country:US
Mailing Address - Phone:502-899-2077
Mailing Address - Fax:502-899-2164
Practice Address - Street 1:6011 BROWNSBORO PARK BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1292
Practice Address - Country:US
Practice Address - Phone:502-899-2077
Practice Address - Fax:502-899-2164
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-7571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0986602Medicare ID - Type Unspecified