Provider Demographics
NPI:1194868273
Name:BLY, NELL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NELL
Middle Name:
Last Name:BLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7538 S STORM MTN
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3807
Mailing Address - Country:US
Mailing Address - Phone:303-932-9440
Mailing Address - Fax:720-981-9000
Practice Address - Street 1:5944 S KIPLING
Practice Address - Street 2:SUITE 300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3807
Practice Address - Country:US
Practice Address - Phone:303-986-5586
Practice Address - Fax:720-981-9000
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9899601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical