Provider Demographics
NPI:1225690597
Name:BREAUX, CYNECIA CUMMIE (LPC)
Entity Type:Individual
Prefix:
First Name:CYNECIA
Middle Name:CUMMIE
Last Name:BREAUX
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 1:6127 WICKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-4686
Mailing Address - Country:US
Mailing Address - Phone:832-515-8707
Mailing Address - Fax:
Practice Address - Street 1:120 ELDRIDGE RD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3185
Practice Address - Country:US
Practice Address - Phone:832-515-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-07
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78169101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health