Healthcare Provider Details

I. General information

NPI: 1396608097
Provider Name (Legal Business Name): CHEYENNE COLLEEN MCFADDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10190 BANNOCK ST STE 120
NORTHGLENN CO
80260-6052
US

IV. Provider business mailing address

1830 NEWLAND CT APT 311
LAKEWOOD CO
80214-1429
US

V. Phone/Fax

Practice location:
  • Phone: 303-237-6865
  • Fax:
Mailing address:
  • Phone: 469-964-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: