Individual
MRS. MARTHA ODEGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
606 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-2779
(720) 340-2387
Mailing address
606 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-2779
(720) 340-2387
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CSW.09924046
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0001093
CO
101YP2500X
Professional Counselor
CSW.09924046
CO
104100000X
Social Worker
CSW.09924046
CO
Other
Enumeration date
07/28/2015
Last updated
05/07/2024
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