Provider Demographics
NPI:1487305249
Name:DARDA, JAIME M (LCSW)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:M
Last Name:DARDA
Suffix:
Gender:F
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:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-0471
Mailing Address - Country:US
Mailing Address - Phone:985-447-8181
Mailing Address - Fax:
Practice Address - Street 1:196 JOHNNY DUFRENE DR
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-2609
Practice Address - Country:US
Practice Address - Phone:985-532-6112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA118981041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool