Provider Demographics
NPI:1184047391
Name:ENGLAND, DARYL (LCSW)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W VANDAMENT AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4654
Mailing Address - Country:US
Mailing Address - Phone:405-760-7758
Mailing Address - Fax:
Practice Address - Street 1:401 W VANDAMENT AVE
Practice Address - Street 2:STE 103
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4654
Practice Address - Country:US
Practice Address - Phone:405-760-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical