Provider Demographics
NPI:1831936608
Name:ODEFEY, DARYL WILLIAM (LCSW)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:WILLIAM
Last Name:ODEFEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S LOGAN ST APT 502
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-1852
Mailing Address - Country:US
Mailing Address - Phone:720-231-2263
Mailing Address - Fax:
Practice Address - Street 1:35 S LOGAN ST APT 502
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-1852
Practice Address - Country:US
Practice Address - Phone:720-231-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099263451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical