Darwin Ray Kellicut, MSW is a
Marriage & Family Therapist based in Coeur D Alene, Idaho. Darwin Ray Kellicut is licensed to practice in Washington (license number LF00001127) and his current practice location is
1420 Lincoln Way Ste 500, Coeur D Alene, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 667-8474.
NPI number for Darwin Ray Kellicut is 1417965781 and his current mailing address is 1420 Lincoln Way Ste 500, Coeur D Alene, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417965781.
Healthcare Provider's Profile
| Full Name | Darwin Ray Kellicut |
|---|
| Gender | Male |
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| Speciality | Marriage & Family Therapist |
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| Location | 1420 Lincoln Way Ste 500, Coeur D Alene, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417965781
- Provider Enumeration Date: 08/03/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Darwin Ray Kellicut such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417965781 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | LCSW 179 (Idaho) | Primary |
| 1041C0700X | Social Worker - Clinical | LW00004911 (Washington) | Primary |
| 106H00000X | Marriage & Family Therapist | LMFT 3089 (Idaho) | Primary |
| 106H00000X | Marriage & Family Therapist | LF00001127 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Darwin Ray Kellicut is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Darwin Ray Kellicut, MSW
1420 Lincoln Way Ste 500,
Coeur D Alene, ID 83814-2391
Ph: (208) 667-8474 | Darwin Ray Kellicut, MSW
1420 Lincoln Way Ste 500,
Coeur D Alene, ID 83814-2391
Ph: (208) 667-8474 |
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