Organization
BELLAVISTA PROFESSIONAL COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANUEL F CARRILLO LCSW (PSYCHOTHERAPIST/OWNER)
(720) 297-6150
Entity
Organization
Contact information
Practice address
190 E 9TH AVE, SUITE 140, DENVER, CO 80203-2736
(720) 297-6150
Mailing address
225 S BROADWAY, UNIT 9945, DENVER, CO 80209-1540
(720) 297-6150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1580
CO
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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