Provider Demographics
NPI:1306523402
Name:BALLINGER-DIX, ELIZABETH (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BALLINGER-DIX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:LUCCI-RIMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1700 W PLUM ST APT 58H
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-3804
Mailing Address - Country:US
Mailing Address - Phone:510-393-4338
Mailing Address - Fax:
Practice Address - Street 1:3500 JOHN F KENNEDY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2635
Practice Address - Country:US
Practice Address - Phone:970-889-8204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health