Provider Demographics
NPI:1982271581
Name:HILLERY, DARRELL (MSW)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:
Last Name:HILLERY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 BALTIMORE NATIONAL PIKE STE 200C
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2930
Mailing Address - Country:US
Mailing Address - Phone:443-636-5760
Mailing Address - Fax:
Practice Address - Street 1:6120 BALTIMORE NATIONAL PIKE STE 200C
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-2930
Practice Address - Country:US
Practice Address - Phone:443-636-5760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder