Provider Demographics
NPI:1699143305
Name:DATO, CYNCHA PHILLIPS (LPC)
Entity type:Individual
Prefix:MRS
First Name:CYNCHA
Middle Name:PHILLIPS
Last Name:DATO
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 1:161 HIGH ST SE STE 235
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3955
Mailing Address - Country:US
Mailing Address - Phone:503-560-0802
Mailing Address - Fax:971-273-7253
Practice Address - Street 1:161 HIGH ST SE STE 235
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3955
Practice Address - Country:US
Practice Address - Phone:503-560-0802
Practice Address - Fax:971-273-7253
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC5680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health