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General NPI Number Information
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NPI Number | 1588576920
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Entity Type | Organization
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Legal Business Name | COSMIC BEHAVIOR THERAPY
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 2827 HUDSON ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-2936
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Country | US
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Telephone | 786-508-4578
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 AUSTIN BLUFFS PKWY STE 31-1038
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-6671
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Country | US
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Telephone | 786-508-4578
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Fax |
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Authorized Official
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Title or Position | OWNER/BCBA
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Name | CECILIA C MADIEDO
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Credential | BCBA
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Telephone | 786-508-4578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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