Provider Demographics
NPI:1215206115
Name:HANKS, CINDY L (MFT, NCC, LPC, REV)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:HANKS
Suffix:
Gender:F
Credentials:MFT, NCC, LPC, REV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E SAINT LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3211
Mailing Address - Country:US
Mailing Address - Phone:702-734-2223
Mailing Address - Fax:702-369-5962
Practice Address - Street 1:1000 E SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3211
Practice Address - Country:US
Practice Address - Phone:702-734-2223
Practice Address - Fax:702-369-5962
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242158- LIC. MIN.101YP1600X
NCNCC-266910101YP2500X
MI6401000336-LPC101YP2500X
NV0823 MFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional