Healthcare Provider Details

I. General information

NPI: 1194224626
Provider Name (Legal Business Name): CYNTHIA ST.CLAIR LCMHC, LPC, R-DMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2018
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WALDEN RIDGE DR STE 80
ASHEVILLE NC
28803-8598
US

IV. Provider business mailing address

3016 N RACE ST
DENVER CO
80205-4560
US

V. Phone/Fax

Practice location:
  • Phone: 919-323-2071
  • Fax:
Mailing address:
  • Phone: 718-974-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19805
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0014793
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License NumberNLC.0106044
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: