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NPI Code Detail

MEDICARE: CYNTHIA MOTT LCPC

MEDICARE: CYNTHIA MOTT LCPC
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
1101Y00000XCounselorLCPC-8041ID

General Provider Information

NPI Number : 1568682409
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA MOTT LCPC
Provider Business Mailing Address
First Line : PO BOX 9
Second Line :
City : NAMPA
State : ID
Zip : 83653-0009
Country : US
Telephone Number : 208-467-4431
Fax Number : 208-467-3391
Provider Business Practice Location Address
First Line : 2005 ARLINGTON AVE
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4808
Country : US
Telephone Number : 208-318-1362
Fax Number : 208-345-3502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 11/28/2023

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