MEDICARE: DR. CYNTHIA RAE CLAPPER PHD, LPCP

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	101YM0800X	Mental Health Counselor	LCPC-384	ID

General Provider Information

NPI Number	:	1588711147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA RAE CLAPPER PHD, LPCP

Provider Business Mailing Address
First Line	:	3440 DAVIS LN
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6450
Country	:	US
Telephone Number	:	208-870-4555
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 WEST DAVIS LANE
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-6450
Country	:	US
Telephone Number	:	208-870-4555
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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