Healthcare Provider Details

I. General information

NPI: 1326358201
Provider Name (Legal Business Name): DANIEL PATRICK O'DONNELL PHD, LMHC, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

660 BANNOCK ST #MC1923
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-4844
  • Fax: 303-436-5157
Mailing address:
  • Phone: 303-436-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8613
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0600653
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number11223
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY.0005685
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: