Provider Demographics
NPI:1750356499
Name:DARMODY, COLLEEN (PMHNP-BC WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:
Last Name:DARMODY
Suffix:
Gender:F
Credentials:PMHNP-BC WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3073 BRIDGETON CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1152
Mailing Address - Country:US
Mailing Address - Phone:703-216-1495
Mailing Address - Fax:
Practice Address - Street 1:3073 BRIDGETON CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-1152
Practice Address - Country:US
Practice Address - Phone:703-216-1495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024086302363LX0001X
MDAC006459363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology