MEDICARE: CYNTHIA LITTON-FANNING, LCSW LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	991621	CO

General Provider Information

NPI Number	:	1104072156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYNTHIA LITTON-FANNING, LCSW LLC

Provider Business Mailing Address
First Line	:	343 W. DRAKE ROAD
Second Line	:	SUITE 260
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-207-1080
Fax Number	:	970-207-1080

Provider Business Practice Location Address
First Line	:	343 W. DRAKE ROAD
Second Line	:	SUITE 260
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-207-1080
Fax Number	:	970-207-1080

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	MS. CYNTHIA ANN LITTON-FANNING
Credential	:	LCSW
Telephone Number	:	970-207-1080

Provider Enumeration Date	:	08/11/2008
Last Update Date	:	08/11/2008

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