Provider Demographics
NPI:1588952824
Name:DOOLY, CINDY JO (LPC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:JO
Last Name:DOOLY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 LAKE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2719
Mailing Address - Country:US
Mailing Address - Phone:972-351-0045
Mailing Address - Fax:
Practice Address - Street 1:6350 N I 35
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5603
Practice Address - Country:US
Practice Address - Phone:866-416-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15103101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor