Provider Demographics
NPI:1447656772
Name:CABRAL, OSVALDO (LPC, CAC III)
Entity type:Individual
Prefix:
First Name:OSVALDO
Middle Name:
Last Name:CABRAL
Suffix:
Gender:M
Credentials:LPC, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-1892
Mailing Address - Country:US
Mailing Address - Phone:720-636-3896
Mailing Address - Fax:
Practice Address - Street 1:1178 MARIPOSA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3507
Practice Address - Country:US
Practice Address - Phone:720-608-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0006142101YA0400X
COLPC.0006099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)