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General NPI Number Information
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NPI Number | 1518727437
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Entity Type | Individual
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Provider Name | CYNTHIA L. BLACK MS, NCC, MFT-INTERN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 701 JONES ST
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City | RENO
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State | NV
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Zip | 89503-5507
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Country | US
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Telephone | 775-742-3488
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Fax |
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Provider Business Mailing Address
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Address Line | 6150 VALLEY WOOD DR
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City | RENO
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State | NV
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Zip | 89523-1242
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Country | US
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Telephone | 775-721-3615
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI4274
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License Number State | NV
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