Healthcare Provider Details

I. General information

NPI: 1740191550
Provider Name (Legal Business Name): DEANA CUNNINGHAM MFTC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST # 4129
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST # 4129
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 970-703-6959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0015044
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: