Provider Demographics
NPI:1548274046
Name:WALMER, DARRELL G (MA LPC)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:G
Last Name:WALMER
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-1602
Mailing Address - Country:US
Mailing Address - Phone:717-665-2675
Mailing Address - Fax:717-665-6193
Practice Address - Street 1:108 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-1602
Practice Address - Country:US
Practice Address - Phone:717-665-2675
Practice Address - Fax:717-665-6193
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional