Provider Demographics
NPI:1447894233
Name:SOUSER, CINDY LYNN
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:LYNN
Last Name:SOUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 ROSLYN ST APT 501
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6462
Mailing Address - Country:US
Mailing Address - Phone:720-838-7826
Mailing Address - Fax:
Practice Address - Street 1:1660 ALBION ST.
Practice Address - Street 2:#700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-8023
Practice Address - Country:US
Practice Address - Phone:720-838-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001092106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty