Basic Information
Provider Information
NPI: 1366768210
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARLING-FUNK
FirstName: EMILY
MiddleName: ALISON
NamePrefix: MRS.
NameSuffix:  
Credential: M.S. , LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 375 APPLE TREE DR
Address2:  
City: IONIA
State: MI
PostalCode: 488467506
CountryCode: US
TelephoneNumber: 6165271790
FaxNumber:  
Practice Location
Address1: 375 APPLE TREE DR
Address2:  
City: IONIA
State: MI
PostalCode: 488467506
CountryCode: US
TelephoneNumber: 6165271790
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/18/2010
LastUpdateDate: 07/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X6401011570MIY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home