Individual provider Active NPI

Darryl J. Huels, LCSW

  • Clinical Social Worker
  • Bradford, PA
National Provider Identifier
1679750624
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R048644 Issued in NY
Practice address
90 Winter St Apt 1
Bradford, PA 16701-1283
Phone
(716) 481-1472
NPI assigned
Jan 22, 2008
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 26967 CA
Clinical Social Worker 1041C0700X R048644 NY Primary

Addresses

Primary practice location

90 Winter St Apt 1
Bradford, PA 16701-1283

Mailing address

54 S Kendall Ave Unit 3
Bradford, PA 16701-1782
Phone (716) 481-1472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, NE3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090814000038 NY Practitioner - Clinical Social Worker 4587718259 Reassigns benefits to 1 organization
I20240508002640 CA Practitioner - Clinical Social Worker 4587718259 Reassigns benefits to 1 organization
I20260624004531 NE Practitioner - Mental Health Counselor 4587718259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26967CAMDSocial Worker
LCS 26967CAMDClinical Social Worker
048644NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Apr 12, 2024 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 12, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1679750624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 S KENDALL AVE UNIT 3",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011782",
            "telephone_number": "716-481-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WINTER ST APT 1",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011283",
            "telephone_number": "716-481-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUELS",
        "first_name": "DARRYL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-22",
        "last_updated": "2023-08-29",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 26967",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R048644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

Verify at the official NPI Registry.