Healthcare Provider Details

I. General information

NPI: 1063769289
Provider Name (Legal Business Name): CYNTHIA E BYAS MS MA LMFT LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 03/11/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36TH MEDICAL GROUP UNIT 14010 BLDG 26012
APO AP
96543-4003
US

IV. Provider business mailing address

999 S MARINE CORPS DR # 405
TAMUNING GU
96913-3415
US

V. Phone/Fax

Practice location:
  • Phone: 671-366-3326
  • Fax:
Mailing address:
  • Phone: 843-605-3967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number374
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4624
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: