Provider Demographics
NPI:1326264201
Name:FULBRIGHT, CYNTHIA ANNETTE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANNETTE
Last Name:FULBRIGHT
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S FM 1417
Mailing Address - Street 2:APT #7109
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4828
Mailing Address - Country:US
Mailing Address - Phone:903-868-8494
Mailing Address - Fax:
Practice Address - Street 1:315 W MCLAIN DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-2605
Practice Address - Country:US
Practice Address - Phone:903-957-4724
Practice Address - Fax:903-957-4745
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17596101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional