Provider Demographics
NPI:1548533094
Name:DARBY, MIKI (LCSW)
Entity type:Individual
Prefix:
First Name:MIKI
Middle Name:
Last Name:DARBY
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 1:9 MONROE PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8865
Mailing Address - Country:US
Mailing Address - Phone:503-926-9457
Mailing Address - Fax:
Practice Address - Street 1:9 MONROE PKWY STE 240
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8865
Practice Address - Country:US
Practice Address - Phone:503-926-9457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORM5219104100000X
ORL52191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker