Provider Demographics
NPI:1730896275
Name:DARNELL, CARLA CHERISE
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:CHERISE
Last Name:DARNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 EVANS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45204-2075
Mailing Address - Country:US
Mailing Address - Phone:513-222-5369
Mailing Address - Fax:
Practice Address - Street 1:4940 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-3619
Practice Address - Country:US
Practice Address - Phone:937-310-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH183591101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator