Healthcare Provider Details

I. General information

NPI: 1235909029
Provider Name (Legal Business Name): DAYRON K BLACKWELL LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 QUEBEC ST STE 7600
DENVER CO
80207-2345
US

IV. Provider business mailing address

3401 QUEBEC ST STE 7600
DENVER CO
80207-2345
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax:
Mailing address:
  • Phone: 970-310-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0023134
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: