Provider Demographics
NPI:1558378828
Name:SPAULDING, CYNTHIA D (MA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:D
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:123 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-8057
Mailing Address - Country:US
Mailing Address - Phone:304-615-9654
Mailing Address - Fax:304-861-5187
Practice Address - Street 1:1809 DUPONT RD STE 3
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-9704
Practice Address - Country:US
Practice Address - Phone:304-861-5184
Practice Address - Fax:304-861-5187
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0164840000Medicaid
WV001705851Medicare UPIN
WV371673Medicare UPIN
WV115328276Medicare UPIN