Provider Demographics
NPI:1114349875
Name:STUBBLEFIELD, CYNTHIA KAYE (MS, LPC CAND)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAYE
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:MS, LPC CAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4660
Mailing Address - Country:US
Mailing Address - Phone:918-248-4340
Mailing Address - Fax:918-248-4345
Practice Address - Street 1:724 S MISSION ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4660
Practice Address - Country:US
Practice Address - Phone:918-248-4340
Practice Address - Fax:918-248-4345
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional