MEDICARE: CYNTHIA CONRRADO LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC.0016869	CO
2	101YM0800X	Mental Health Counselor	LPCC.0016034	CO
3	101YP2500X	Professional Counselor	LPC.0016869	CO

General Provider Information

NPI Number	:	1225529910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CONRRADO LPC

Provider Business Mailing Address
First Line	:	5555 ERINDALE DR STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6736
Country	:	US
Telephone Number	:	719-432-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 ERINDALE DR STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6736
Country	:	US
Telephone Number	:	719-432-7910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	07/28/2023

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