Provider Demographics
NPI:1235152166
Name:RILEY, CYNTHIA B (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:B
Last Name:RILEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:B
Other - Last Name:ELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:310 E DEL NORTE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7512
Mailing Address - Country:US
Mailing Address - Phone:719-360-6022
Mailing Address - Fax:
Practice Address - Street 1:310 E DEL NORTE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-360-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist