Individual provider Active NPI

Marty Lees Daugherty, LCSW

  • Clinical Social Worker
  • Aurora, CO
National Provider Identifier
1598043218
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.00989043 Issued in CO
Practice address
14555 E Hampden Ave
Aurora, CO 80014-5041
Phone
(303) 278-7418
Fax
(888) 341-5050
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 989043 CO
Clinical Social Worker 1041C0700X CSW.00989043 CO Primary

Addresses

Primary practice location

14555 E Hampden Ave
Aurora, CO 80014-5041

Mailing address

4860 Robb St Ste 201
Wheat Ridge, CO 80033-2162
Phone (303) 278-7418

Other practice location 1

1432 Depew St
Lakewood, CO 80214-2237
Phone (303) 238-1375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
989043COMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598043218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 ROBB ST STE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332162",
            "telephone_number": "303-278-7418",
            "fax_number": "888-341-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 E HAMPDEN AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800145041",
            "telephone_number": "303-278-7418",
            "fax_number": "888-341-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1432 Depew St",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802142237",
            "country_code": "US",
            "telephone_number": "303-238-1375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "MARTY",
        "middle_name": "LEES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "989043",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.00989043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.