Provider Demographics
NPI:1699261602
Name:ORDONEZ-BRANCO, CYNTHIA (LMFT, LADAC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ORDONEZ-BRANCO
Suffix:
Gender:F
Credentials:LMFT, LADAC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:STINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT, LADAC
Mailing Address - Street 1:PO BOX 2314
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-2314
Mailing Address - Country:US
Mailing Address - Phone:575-635-7832
Mailing Address - Fax:
Practice Address - Street 1:225 E IDAHO AVE STE 30
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3242
Practice Address - Country:US
Practice Address - Phone:575-635-7832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAD0210221101YA0400X
NMCMF0219121106H00000X, 106H00000X
NMCAMF0207241106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM04700350Medicaid
NM95370561Medicaid