Individual provider Active NPI

Darnell Lollis

  • Clinical Social Worker
  • Mount Vernon, WA
National Provider Identifier
1720503584
Registry record updated Oct 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC60739879 Issued in WA
Practice address
1100 S 2ND St # 2
Mount Vernon, WA 98273-4209
Phone
(425) 349-6200
NPI assigned
Aug 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SC60739879 WA Primary

Addresses

Primary practice location

1100 S 2ND St # 2
Mount Vernon, WA 98273-4209

Mailing address

1100 S 2ND St # 2
Mount Vernon, WA 98273-4209
Phone (425) 319-1242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SC60739879WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1502582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508025600000",
    "number": "1720503584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S 2ND ST # 2",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734209",
            "telephone_number": "425-319-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S 2ND ST # 2",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734209",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLLIS",
        "first_name": "DARNELL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-13",
        "last_updated": "2017-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60739879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.