Individual
DARWIN RAY KELLICUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1420 LINCOLN WAY STE 500, COEUR D ALENE, ID 83814-2391
(208) 667-8474
(208) 665-5704
Mailing address
1420 LINCOLN WAY STE 500, COEUR D ALENE, ID 83814-2391
(208) 667-8474
(208) 665-5704
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW 179
ID
1041C0700X
Clinical Social Worker
LW00004911
WA
106H00000X
Marriage & Family Therapist
Primary
LF00001127
WA
106H00000X
Marriage & Family Therapist
LMFT 3089
ID
Other
Enumeration date
08/03/2006
Last updated
09/11/2025
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