Provider Demographics
NPI:1811093016
Name:HURD-TERPSTRA, CYNTHIA ELLEN (MPH, LCSW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELLEN
Last Name:HURD-TERPSTRA
Suffix:
Gender:F
Credentials:MPH, LCSW
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:ELLEN
Other - Last Name:HURD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH, LCSW
Mailing Address - Street 1:4344 WESTBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3455
Mailing Address - Country:US
Mailing Address - Phone:970-481-0146
Mailing Address - Fax:970-232-3101
Practice Address - Street 1:155 BOARDWALK DR STE 400
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3040
Practice Address - Country:US
Practice Address - Phone:970-481-0146
Practice Address - Fax:970-232-3101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSW 2881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC809849Medicare PIN