Healthcare Provider Details

I. General information

NPI: 1457308819
Provider Name (Legal Business Name): CYNTHIA WINTERS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7325 US HIGHWAY 93 SUITE A
LAKESIDE MT
59922-9704
US

IV. Provider business mailing address

202 CONWAY DR SUITE 100
KALISPELL MT
59901-3112
US

V. Phone/Fax

Practice location:
  • Phone: 406-844-2890
  • Fax: 406-844-2891
Mailing address:
  • Phone: 406-751-5664
  • Fax: 406-755-0971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1084 LCPC
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: