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General NPI Number Information
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NPI Number | 1083064356
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Entity Type | Individual
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Provider Name | CYNTHIA KEARNEY LPC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 1452 HUGHES RD STE 200
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City | GRAPEVINE
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State | TX
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Zip | 76051-7366
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Country | US
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Telephone | 336-905-4188
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Fax |
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Provider Business Mailing Address
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Address Line | 8356 BOWSPIRIT LN
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City | HURST
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State | TX
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Zip | 76053-7424
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Country | US
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Telephone | 336-905-4188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 72507
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License Number State | TX
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