Provider Demographics
NPI:1770761520
Name:MAYNARD, DARLA DAVIS (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:DAVIS
Last Name:MAYNARD
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 1:10900 W 86TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-3608
Mailing Address - Country:US
Mailing Address - Phone:913-499-8100
Mailing Address - Fax:
Practice Address - Street 1:10900 W 86TH ST STE 150
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-3608
Practice Address - Country:US
Practice Address - Phone:913-499-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS66911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical