Provider Demographics
NPI:1992117808
Name:CYNDIE FORD PURDY, LMHC
Entity type:Organization
Organization Name:CYNDIE FORD PURDY, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNDIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FORD PURDY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC, MAC, SAP
Authorized Official - Phone:352-341-0435
Mailing Address - Street 1:470 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-5746
Mailing Address - Country:US
Mailing Address - Phone:352-341-0435
Mailing Address - Fax:352-341-1562
Practice Address - Street 1:470 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-5746
Practice Address - Country:US
Practice Address - Phone:352-341-0435
Practice Address - Fax:352-341-1562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1528115599OtherNPI
FL509619147OtherUNITED BEHAVIORAL HEALTH
FL11587556OtherCAQH
FL225450000OtherMAGELLAN HEALTH SERVICES
FLZ9845OtherBLUE CROSS BLUE SHIELD OF FL