Provider Demographics
NPI:1760359897
Name:ODYSSEY COUNSELING AND THERAPY LLC
Entity type:Organization
Organization Name:ODYSSEY COUNSELING AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-552-7144
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-0128
Mailing Address - Country:US
Mailing Address - Phone:914-552-7144
Mailing Address - Fax:
Practice Address - Street 1:173 GRAY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2514
Practice Address - Country:US
Practice Address - Phone:914-552-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty