Provider Demographics
NPI:1275216491
Name:NEWLAND, CYNTHIA (MFA, CHC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:NEWLAND
Suffix:
Gender:F
Credentials:MFA, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 EASTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6115
Mailing Address - Country:US
Mailing Address - Phone:601-209-1655
Mailing Address - Fax:
Practice Address - Street 1:4540 EASTWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-6115
Practice Address - Country:US
Practice Address - Phone:601-209-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS399747101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral