Provider Demographics
NPI:1013002120
Name:CROSBY, CYNTHIA (LMFT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CROSBY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 5535
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90409-5535
Mailing Address - Country:US
Mailing Address - Phone:310-902-6165
Mailing Address - Fax:310-390-3677
Practice Address - Street 1:744 1/2 FLOWER AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-5435
Practice Address - Country:US
Practice Address - Phone:310-902-6165
Practice Address - Fax:310-390-3677
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25408106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist