Provider Demographics
NPI:1427632363
Name:STOCUM, CYNTHIA (LPC-A)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:STOCUM
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 SPRING CROSSING CIR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-5101
Mailing Address - Country:US
Mailing Address - Phone:864-397-0431
Mailing Address - Fax:
Practice Address - Street 1:149 SPRING CROSSING CIR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5101
Practice Address - Country:US
Practice Address - Phone:864-397-0431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional