Provider Demographics
NPI:1073725487
Name:TRAVNICEK, CYNTHIA M (LCPC, BCC, CHT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:M
Last Name:TRAVNICEK
Suffix:
Gender:F
Credentials:LCPC, BCC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9051
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60598-9051
Mailing Address - Country:US
Mailing Address - Phone:630-234-0067
Mailing Address - Fax:
Practice Address - Street 1:3371 HELENE RIEDER DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-6025
Practice Address - Country:US
Practice Address - Phone:630-234-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006380101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional