Healthcare Provider Details
I. General information
NPI: 1760174700
Provider Name (Legal Business Name): DARCIE O'CONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/25/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7500 W MISSISSIPPI AVE # 200
LAKEWOOD CO
80226-4550
US
IV. Provider business mailing address
2765 WESTGATE AVE
HIGHLANDS RANCH CO
80126-7517
US
V. Phone/Fax
- Phone: 855-678-3144
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: