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NPI Code Detail

MEDICARE: MS. BRYNA SARA CUNNINGHAM LCSW

MEDICARE: MS. BRYNA SARA CUNNINGHAM LCSW
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
11041C0700XClinical Social Worker359CO

General Provider Information

NPI Number : 1538706759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRYNA SARA CUNNINGHAM LCSW
Provider Business Mailing Address
First Line : 4819 RAVEN RUN
Second Line :
City : BROOMFIELD
State : CO
Zip : 80023-4638
Country : US
Telephone Number : 303-257-8875
Fax Number :
Provider Business Practice Location Address
First Line : 1400 MAIN ST STE 101
Second Line :
City : LOUISVILLE
State : CO
Zip : 80027-3046
Country : US
Telephone Number : 303-882-5448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2019
Last Update Date : 11/29/2022

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