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General NPI Number Information
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NPI Number | 1528286515
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Entity Type | Individual
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Provider Name | CYNTHIA HEATHER ROSE LMFT, CACIII
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 1023 COUNTY ROAD 610
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City | GRANBY
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State | CO
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Zip | 80446
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Country | US
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Telephone | 970-887-2179
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Fax | 970-887-9311
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81602-0040
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Country | US
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Telephone | 970-945-2241
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 843
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000063
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 7201
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 44437
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License Number State | CA
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