Provider Demographics
NPI:1679805964
Name:PERCY, CINDY L (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:L
Last Name:PERCY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 N 8TH AVE
Mailing Address - Street 2:PO BOX 640
Mailing Address - City:HOLBROOK
Mailing Address - State:AZ
Mailing Address - Zip Code:86025-2334
Mailing Address - Country:US
Mailing Address - Phone:928-524-2815
Mailing Address - Fax:928-524-3537
Practice Address - Street 1:455 N 8TH AVE
Practice Address - Street 2:HOLBROOK HIGH SCHOOL
Practice Address - City:HOLBROOK
Practice Address - State:AZ
Practice Address - Zip Code:86025-2334
Practice Address - Country:US
Practice Address - Phone:928-524-2815
Practice Address - Fax:928-524-3537
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001957101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health