Provider Demographics
NPI:1386945327
Name:BOYLE, CYNTHIA RENEE (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:RENEE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-2907
Mailing Address - Country:US
Mailing Address - Phone:319-610-4179
Mailing Address - Fax:888-853-4291
Practice Address - Street 1:1409 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-2907
Practice Address - Country:US
Practice Address - Phone:319-610-4179
Practice Address - Fax:888-853-4291
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019661101YP2500X
MT55918101YP2500X
IA001289101YM0800X
WI10230-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional