Provider Demographics
NPI:1053498501
Name:INMAN, CINDY CARLSON (MA, LP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:CARLSON
Last Name:INMAN
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:ADELE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LP
Mailing Address - Street 1:1385 BURNFIELD RD
Mailing Address - Street 2:
Mailing Address - City:VINCENT
Mailing Address - State:OH
Mailing Address - Zip Code:45784-5174
Mailing Address - Country:US
Mailing Address - Phone:740-989-2179
Mailing Address - Fax:
Practice Address - Street 1:2121 7TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3803
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:304-485-6710
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV729103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV729OtherPSYCHOLOGY LICENSE NUMBER