Basic Information
Provider Information
NPI: 1174625891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILAS
FirstName: CYNTHIA
MiddleName: LYNN
NamePrefix: MS.
NameSuffix:  
Credential: MA LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7750 92ND ST N
Address2: #203H
City: SEMINOLE
State: FL
PostalCode: 33777
CountryCode: US
TelephoneNumber: 7272152295
FaxNumber:  
Practice Location
Address1: 300 PINELLAS ST
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337563804
CountryCode: US
TelephoneNumber: 7274618231
FaxNumber: 7272986080
Other Information
ProviderEnumerationDate: 09/02/2006
LastUpdateDate: 11/16/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XMH5758FLY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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