Provider Demographics
NPI:1215039383
Name:OPDYKE, DANIEL C (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:OPDYKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 7TH ST NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5113
Mailing Address - Country:US
Mailing Address - Phone:828-485-2195
Mailing Address - Fax:828-485-2197
Practice Address - Street 1:321 7TH ST NE
Practice Address - Street 2:SUITE B
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5113
Practice Address - Country:US
Practice Address - Phone:828-485-2195
Practice Address - Fax:828-485-2197
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2404103T00000X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2341442AMedicare ID - Type Unspecified