Healthcare Provider Details

I. General information

NPI: 1063051415
Provider Name (Legal Business Name): MORGAN DINGLE BELLINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 30TH ST STE A124
BOULDER CO
80301-1044
US

IV. Provider business mailing address

1630 30TH ST STE A124
BOULDER CO
80301-1044
US

V. Phone/Fax

Practice location:
  • Phone: 720-258-6448
  • Fax:
Mailing address:
  • Phone: 720-258-6448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0017733
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: