Provider Demographics
NPI:1194382333
Name:MURCHISON-GRICE, CYNTHIA GALE (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GALE
Last Name:MURCHISON-GRICE
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 1:14203 OLD COURTHOUSE WAY STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-3749
Mailing Address - Country:US
Mailing Address - Phone:757-522-7011
Mailing Address - Fax:
Practice Address - Street 1:14203 OLD COURTHOUSE WAY STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-3749
Practice Address - Country:US
Practice Address - Phone:757-522-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health