Healthcare Provider Details

I. General information

NPI: 1407178767
Provider Name (Legal Business Name): CYNTHIA M ROBY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 06/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

788 LEXINGTON AVE
MANSFIELD OH
44907-1921
US

IV. Provider business mailing address

788 LEXINGTON AVE
MANSFIELD OH
44907-1921
US

V. Phone/Fax

Practice location:
  • Phone: 419-756-2828
  • Fax: 419-756-9133
Mailing address:
  • Phone: 419-756-2828
  • Fax: 419-756-9913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0500416
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberOH1007589
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: