MEDICARE: MS. CYNTHIA B POPE MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	NCBLPC4528	NC

General Provider Information

NPI Number	:	1093839466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA B POPE MA, LPC

Provider Business Mailing Address
First Line	:	8307 UNIVERSITY EXECUTIVE PARK DR
Second Line	:	SUITE 256
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1360
Country	:	US
Telephone Number	:	704-548-3500
Fax Number	:	704-849-6795

Provider Business Practice Location Address
First Line	:	8307 UNIVERSITY EXECUTIVE PARK DR
Second Line	:	SUITE 256
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1360
Country	:	US
Telephone Number	:	704-548-3500
Fax Number	:	704-849-6795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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