Healthcare Provider Details

I. General information

NPI: 1992111348
Provider Name (Legal Business Name): CINDY BRODY L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 ADAMS ST
DENVER CO
80206-5213
US

IV. Provider business mailing address

257 ADAMS ST
DENVER CO
80206-5213
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-2333
  • Fax:
Mailing address:
  • Phone: 303-322-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number988004
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: