Provider Demographics
NPI:1801113634
Name:PORTER, CINTA WATSON
Entity type:Individual
Prefix:MRS
First Name:CINTA
Middle Name:WATSON
Last Name:PORTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CINTA
Other - Middle Name:CARMEN
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1313 S CLARKSON ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2283
Mailing Address - Country:US
Mailing Address - Phone:303-744-7100
Mailing Address - Fax:
Practice Address - Street 1:1313 S CLARKSON ST
Practice Address - Street 2:UNIT 1
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2283
Practice Address - Country:US
Practice Address - Phone:303-744-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical