Hairston, Cynthia Dianne

Hairston, Cynthia Dianne is an individual health care provider with primary practice located at 1 Hargrove Grade Ste 1B , Palm Coast FL 32137-5116. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Hairston, Cynthia Dianne can be contacted via phone (386) 643-3115.

Contact Information

Primary practice address
1 Hargrove Grade Ste 1B Palm Coast FL 32137-5116
Phone: (386) 643-3115
Fax: (386) 276-3474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH12217 Florida

Profile Details

NPI number 1437276912
LBN Legal business name Hairston, Cynthia Dianne
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Jun 15th, 2020 - 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 1437276912 NPPES
Florida Other MH12217 STATE LICENSE

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