Provider Demographics
NPI:1376790345
Name:TANGREN, CYNDI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNDI
Middle Name:
Last Name:TANGREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2118
Mailing Address - Country:US
Mailing Address - Phone:801-940-0470
Mailing Address - Fax:435-734-2719
Practice Address - Street 1:120 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-2118
Practice Address - Country:US
Practice Address - Phone:435-723-2881
Practice Address - Fax:435-734-2719
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT371307-3502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health