Provider Demographics
NPI:1699138693
Name:AVERS, CYNTHIA (MA, LCPC, NCC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:AVERS
Suffix:
Gender:F
Credentials:MA, LCPC, NCC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LOUISE
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 EDINBURGH CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-7706
Mailing Address - Country:US
Mailing Address - Phone:630-290-0501
Mailing Address - Fax:
Practice Address - Street 1:1235 EDINBURGH CT
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-7706
Practice Address - Country:US
Practice Address - Phone:630-290-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
IL180012844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty