Provider Demographics
NPI:1396807368
Name:WITSELL, CYNTHIA LEIGH (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LEIGH
Last Name:WITSELL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HWY. 431 S.
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36869
Mailing Address - Country:US
Mailing Address - Phone:334-298-9328
Mailing Address - Fax:
Practice Address - Street 1:4729 ARMOUR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5228
Practice Address - Country:US
Practice Address - Phone:706-576-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional