Individual provider Active NPI

Cynthia Ann Leblanc, MFT

  • Marriage & Family Therapist
  • Colorado Springs, CO
National Provider Identifier
1427306992
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0001198 Issued in CO
Practice address
2500 N Circle Dr Ste 400
Colorado Springs, CO 80909-1184
Phone
(719) 331-6653
Fax
(719) 623-0458
NPI assigned
Aug 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0001198 CO Primary

Addresses

Primary practice location

2500 N Circle Dr Ste 400
Colorado Springs, CO 80909-1184

Mailing address

1765 Rimwood Dr
Colorado Springs, CO 80918-7874
Phone (719) 331-6653

Other identifiers 1

IdentifierTypeStateIssuer
9000148438MedicaidCO

Other names 1

  • Ms. Cynthia Leblanc Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://rootstoground.clientsecure.me Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213000538 CO Practitioner - Marriage and Family Therapist 3971946385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001198COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roots to Ground Counseling Marriage & Family Therapist CurrentSince Jan 3, 2024 Accepting new patients

Locations

2500 N Circle Dr
Ste 400
Colorado Springs, CO 80909
Phone (719) 331-6653

5540 N Academy Blvd
Ste 210
Colorado Springs, CO 80918
Phone (719) 330-3366

4360 Montebello Dr
Ste 400
Colorado Springs, CO 80918
Phone (719) 593-9228

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1427306992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 RIMWOOD DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809187874",
            "telephone_number": "719-331-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N CIRCLE DR STE 400",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091184",
            "telephone_number": "719-331-6653",
            "fax_number": "719-623-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "0001198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000148438",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://rootstoground.clientsecure.me",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://rootstoground.clientsecure.me",
            "address_1": "2500 N Circle Dr Ste 400",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809091184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "LEBLANC",
            "prefix": "MS.",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.