Provider Demographics
NPI:1306568019
Name:CECIL, CECILIA ALLEEN (LMSW)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:ALLEEN
Last Name:CECIL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-2062
Mailing Address - Country:US
Mailing Address - Phone:208-597-4636
Mailing Address - Fax:
Practice Address - Street 1:1512 POPLAR ST
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-2062
Practice Address - Country:US
Practice Address - Phone:208-597-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor