Provider Demographics
NPI:1669553442
Name:CYR, JANA MORAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:MORAN
Last Name:CYR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:ALANE
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 KIPLING STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5866
Mailing Address - Country:US
Mailing Address - Phone:303-237-9205
Mailing Address - Fax:
Practice Address - Street 1:720 KIPLING STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5866
Practice Address - Country:US
Practice Address - Phone:303-237-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO986091103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
87476Medicare ID - Type Unspecified
87476Medicare UPIN