Healthcare Provider Details

I. General information

NPI: 1538092069
Provider Name (Legal Business Name): DARNELL ANTHONY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 COLORADO AVE
GRAND JUNCTION CO
81501-3522
US

IV. Provider business mailing address

530 PURPLE ASH CIR
CLIFTON CO
81520-6712
US

V. Phone/Fax

Practice location:
  • Phone: 970-244-0562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSW.0009927388
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: