Provider Demographics
NPI:1285117648
Name:UDOFIA, INDHIRA MMEFRE ANIETIE (LCSW)
Entity type:Individual
Prefix:DR
First Name:INDHIRA
Middle Name:MMEFRE ANIETIE
Last Name:UDOFIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W 9TH AVE UNIT 1213
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4032
Mailing Address - Country:US
Mailing Address - Phone:336-663-2819
Mailing Address - Fax:
Practice Address - Street 1:150 W 9TH AVE UNIT 1213
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4032
Practice Address - Country:US
Practice Address - Phone:336-663-2819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040128301041C0700X
COCSW.099294171041C0700X
NCC01323321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical