Provider Demographics
NPI:1679168199
Name:MAGILL, MORGAN LYNNE (BCBA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYNNE
Last Name:MAGILL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 W 88TH CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3570
Mailing Address - Country:US
Mailing Address - Phone:402-689-3965
Mailing Address - Fax:
Practice Address - Street 1:2500 ARAPAHOE AVE STE 230
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6752
Practice Address - Country:US
Practice Address - Phone:432-672-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-21-46916103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst