| Doctor Name: | MS. CYNTHIA COOPER SMOCK |
| NPI Number: | 1376784546 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC, CAC III |
| License Number: | 2606 |
| Business Practice Address: | 107 E Georgia Suite 3e Gunnison, CO - 81230 |
| Business Phone Number: | 9706415119 |
| Business Fax Number: | 9706415118 |
| Mailing Address: | Po Box 801, GUNNISON |
| State: | CO |
| Postal Code: | 81230 |
| Phone Number: | 9706415119 |
| Fax Number: | 9706415118 |
| NPI Enumeration Date: | 03/17/2009 |
| NPI Last Update Date: | 03/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2606 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |