Provider Demographics
NPI:1770160111
Name:BARBOUR-SHIRLEY, DARLENE TERESA (LICSW-DC, LCSW-C MD)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:TERESA
Last Name:BARBOUR-SHIRLEY
Suffix:
Gender:F
Credentials:LICSW-DC, LCSW-C MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15204 PLANE TREE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3020
Mailing Address - Country:US
Mailing Address - Phone:301-602-4034
Mailing Address - Fax:
Practice Address - Street 1:15204 PLANE TREE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3020
Practice Address - Country:US
Practice Address - Phone:301-602-4034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3027401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical