Provider Demographics
NPI:1477949170
Name:DALEW. DARBY, PH.D. CLINICAL AND HEALTH PSYCHOLOGY
Entity Type:Organization
Organization Name:DALEW. DARBY, PH.D. CLINICAL AND HEALTH PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL AND HEALTH PSYCHIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-237-9929
Mailing Address - Street 1:6975 MIKADO LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1313
Mailing Address - Country:US
Mailing Address - Phone:719-237-9929
Mailing Address - Fax:
Practice Address - Street 1:2352 MEADOWS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109
Practice Address - Country:US
Practice Address - Phone:719-237-9929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 256261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health