Healthcare Provider Details

I. General information

NPI: 1811093016
Provider Name (Legal Business Name): CYNTHIA ELLEN HURD-TERPSTRA MPH, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA ELLEN HURD MPH, LCSW

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 BOARDWALK DR STE 400
FORT COLLINS CO
80525-3040
US

IV. Provider business mailing address

4344 WESTBROOKE DR
FORT COLLINS CO
80526-3455
US

V. Phone/Fax

Practice location:
  • Phone: 970-481-0146
  • Fax: 970-232-3101
Mailing address:
  • Phone: 970-481-0146
  • Fax: 970-232-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 288
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: