Provider Demographics
NPI:1073956116
Name:MORGAN, SALLY (LPC)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5946 GUNBARREL AVE APT D
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-5333
Mailing Address - Country:US
Mailing Address - Phone:720-771-2722
Mailing Address - Fax:
Practice Address - Street 1:2095 W 6TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1880
Practice Address - Country:US
Practice Address - Phone:720-771-2722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CO0014176101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health