Basic Information
| Provider Information | |||||||||
| NPI: | 1972844645 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KENNY | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1090 W SOUTH BOUNDARY ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | PERRYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435515249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198738280 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1090 W SOUTH BOUNDARY ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | PERRYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435515249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198738280 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2013 | ||||||||
| LastUpdateDate: | 10/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E.1000427 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.