Provider Demographics
NPI:1528115599
Name:FORD PURDY, CYNDIE A (LMHC, NCC, MAC, SAP)
Entity type:Individual
Prefix:MS
First Name:CYNDIE
Middle Name:A
Last Name:FORD PURDY
Suffix:
Gender:F
Credentials:LMHC, NCC, MAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3356
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34430-3356
Mailing Address - Country:US
Mailing Address - Phone:352-341-0435
Mailing Address - Fax:352-341-1562
Practice Address - Street 1:470 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-5746
Practice Address - Country:US
Practice Address - Phone:352-341-0435
Practice Address - Fax:352-341-1562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK299101Y00000X
FLMH5401101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528115599OtherNPI
FL225450000OtherMAGELLAN HEALTH SERVICES
FL509619147OtherUNITED BEHAVIORAL HEALTH
FLZ 9845OtherBLUE CROSS BLUE SHIELF OF
FL11587556OtherCAQH