Provider Demographics
NPI:1215296256
Name:LEXOW, CINDY (LCP)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:LEXOW
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2540
Mailing Address - Country:US
Mailing Address - Phone:620-340-2939
Mailing Address - Fax:
Practice Address - Street 1:527 COMMERCIAL STREET, SUITE #416
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2556
Practice Address - Country:US
Practice Address - Phone:620-340-2939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS197101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health