Provider Demographics
NPI:1144811167
Name:SYPOLT, DARCEY (LCSW)
Entity type:Individual
Prefix:
First Name:DARCEY
Middle Name:
Last Name:SYPOLT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 HURON PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-6077
Mailing Address - Country:US
Mailing Address - Phone:720-891-5347
Mailing Address - Fax:
Practice Address - Street 1:864 W SOUTH BOULDER RD UNIT 201
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2598
Practice Address - Country:US
Practice Address - Phone:720-891-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.00001656101YM0800X, 1041C0700X
COCSW.0000156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical