Fondren, Cynthia L

Fondren, Cynthia L is an sole proprietor health care provider with primary practice located at 1830 Destiny Ln Ste 104 , Bowling Green KY 42104. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Fondren, Cynthia L can be contacted via phone (270) 901-5000.

Contact Information

Primary practice address
1830 Destiny Ln Ste 104 Bowling Green KY 42104
Phone: (270) 901-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 241316 Kentucky
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1801930425
LBN Legal business name Fondren, Cynthia L
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 16th, 2007
Last updated Jul 2nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801930425 NPPES
Other 830848596 FEDERAL TAX ID
MEDICAID 30604011 FEDERAL TAX ID

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