Provider Demographics
NPI:1003295742
Name:CEYNAR, ALICIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:CEYNAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N ECTOR DR UNIT 852
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-8630
Mailing Address - Country:US
Mailing Address - Phone:817-442-3414
Mailing Address - Fax:
Practice Address - Street 1:1550 NORWOOD DR STE 120
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3646
Practice Address - Country:US
Practice Address - Phone:682-238-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363484202Medicaid