Provider Demographics
NPI:1669985149
Name:MANN, DARLENE (LMSW)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5769 BELT LINE RD APT 1014
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7678
Mailing Address - Country:US
Mailing Address - Phone:469-697-4374
Mailing Address - Fax:
Practice Address - Street 1:5769 BELT LINE RD APT 1014
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7678
Practice Address - Country:US
Practice Address - Phone:469-697-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63236104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker