Provider Demographics
NPI:1699317909
Name:SMITH, CYNTHIA ANNE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:SMITH
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 1:173 CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-7007
Mailing Address - Country:US
Mailing Address - Phone:205-902-3481
Mailing Address - Fax:
Practice Address - Street 1:4000 EAGLE POINT CORPORATE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-1900
Practice Address - Country:US
Practice Address - Phone:205-259-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4161101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor