MEDICARE: CINDY C ADDISON LPC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701005453	VA

General Provider Information

NPI Number	:	1427494475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY C ADDISON LPC, LMFT

Provider Business Mailing Address
First Line	:	454 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-300-4422
Fax Number	:	833-276-0046

Provider Business Practice Location Address
First Line	:	454 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-300-4422
Fax Number	:	833-276-0046

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2013
Last Update Date	:	06/10/2024

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