Provider Demographics
NPI:1912232612
Name:BIONDI, NYLE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:NYLE
Middle Name:
Last Name:BIONDI
Suffix:
Gender:M
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1919
Mailing Address - Country:US
Mailing Address - Phone:608-219-1744
Mailing Address - Fax:720-729-0041
Practice Address - Street 1:1800 30TH ST STE 304
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1026
Practice Address - Country:US
Practice Address - Phone:608-219-1744
Practice Address - Fax:720-729-0041
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001236106H00000X
WI829-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist