MEDICARE: CYNTHIA CABANISS

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	1041	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396774360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CABANISS

Provider Business Mailing Address
First Line	:	217 W 2ND AVE
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-3005
Country	:	US
Telephone Number	:	336-783-6919
Fax Number	:	336-783-6923

Provider Business Practice Location Address
First Line	:	351 RIVERSIDE DR
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-3850
Country	:	US
Telephone Number	:	336-783-6919
Fax Number	:	336-783-6923

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/08/2007

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Directions to “ CYNTHIA CABANISS ” Practice Location

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