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NPI Code Detail

MEDICARE: ODYSSEY COUNSELING AND THERAPY LLC

MEDICARE: ODYSSEY COUNSELING AND THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1760359897
Entity Type Code : Organization
Provider Name (Legal Business Name) : ODYSSEY COUNSELING AND THERAPY LLC
Provider Business Mailing Address
First Line : PO BOX 128
Second Line :
City : YARMOUTH
State : ME
Zip : 04096-0128
Country : US
Telephone Number : 914-552-7144
Fax Number :
Provider Business Practice Location Address
First Line : 173 GRAY RD
Second Line :
City : FALMOUTH
State : ME
Zip : 04105-2514
Country : US
Telephone Number : 914-552-7144
Fax Number :
Authorized Official
Title or Position : CLINICAL SOCIAL WORKER
Name : KIM DECARLO
Credential : LCSW
Telephone Number : 207-200-1096
Provider Enumeration Date : 10/22/2025
Last Update Date : 01/21/2026

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Directions to “ODYSSEY COUNSELING AND THERAPY LLC ” Practice Location

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