Provider Demographics
NPI:1427494475
Name:ADDISON, CINDY C (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:C
Last Name:ADDISON
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3408
Mailing Address - Country:US
Mailing Address - Phone:276-300-4422
Mailing Address - Fax:833-276-0046
Practice Address - Street 1:454 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3408
Practice Address - Country:US
Practice Address - Phone:276-300-4422
Practice Address - Fax:833-276-0046
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional