Bellavista Professional Counseling Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1580 Issued in CO

Legal business name

BELLAVISTA PROFESSIONAL COUNSELING CENTER, LLC

Practice address

190 E 9TH Ave
Suite 140
Denver, CO 80203-2736

Phone

(720) 297-6150

NPI assigned

Aug 14, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Manuel F Carrillo, LCSW

Title

Psychotherapist/Owner

Phone

(720) 297-6150

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1831565621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S BROADWAY",
            "address_2": "UNIT 9945",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802091540",
            "telephone_number": "720-297-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E 9TH AVE",
            "address_2": "SUITE 140",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802032736",
            "telephone_number": "720-297-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAVISTA PROFESSIONAL COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "720-297-6150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.