Provider Demographics
NPI:1750444220
Name:LITTON-FANNING, CYNTHIA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:LITTON-FANNING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:LITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 W DRAKE RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6317
Mailing Address - Country:US
Mailing Address - Phone:970-207-1080
Mailing Address - Fax:970-207-1640
Practice Address - Street 1:343 W DRAKE RD
Practice Address - Street 2:SUITE 260
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6317
Practice Address - Country:US
Practice Address - Phone:970-207-1080
Practice Address - Fax:970-207-1640
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9916211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO613519OtherMEDICARE PTAN