Provider Demographics
NPI:1336586213
Name:FORESMAN, CYNTHIA ANN (LMHP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:FORESMAN
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1943
Mailing Address - Country:US
Mailing Address - Phone:308-537-3691
Mailing Address - Fax:
Practice Address - Street 1:815 LAKE AVE
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-1943
Practice Address - Country:US
Practice Address - Phone:308-537-3691
Practice Address - Fax:308-537-3062
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5014101YM0800X
NE9850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health