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General NPI Number Information
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NPI Number | 1326379579
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Entity Type | Individual
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Provider Name | CYNTHIA SCHMID DESANTIS M.S.W, LCSW, LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 375 E HORSETOOTH RD STE 102
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City | FORT COLLINS
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State | CO
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Zip | 80525-3155
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Country | US
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Telephone | 970-541-0172
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Fax |
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Provider Business Mailing Address
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Address Line | 1001A E HARMONY RD STE 453
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City | FORT COLLINS
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State | CO
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Zip | 80525-3354
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Country | US
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Telephone | 970-541-0172
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10236
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC303423
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09926668
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License Number State | CO
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