Provider Demographics
NPI:1194369389
Name:NICOLAS, CYNTHIA LUBIN (MA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LUBIN
Last Name:NICOLAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8614
Mailing Address - Country:US
Mailing Address - Phone:561-385-9524
Mailing Address - Fax:
Practice Address - Street 1:4101 PARKER AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-2507
Practice Address - Country:US
Practice Address - Phone:561-676-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health