Provider Demographics
NPI:1679173728
Name:KEARNEY, DARLENE (LCDCI,RC,CHW)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LCDCI,RC,CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20696
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77225-0696
Mailing Address - Country:US
Mailing Address - Phone:832-264-7491
Mailing Address - Fax:
Practice Address - Street 1:2626 S LOOP W STE 174
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2873
Practice Address - Country:US
Practice Address - Phone:832-264-7491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 106E00000X, 172V00000X, 251K00000X, 251S00000X
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No172V00000XOther Service ProvidersCommunity Health Worker
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health