Provider Demographics
NPI:1346399078
Name:TRIFON, CYNTHIA DARLENE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:DARLENE
Last Name:TRIFON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:TRIFON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:801 N D ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6020
Mailing Address - Country:US
Mailing Address - Phone:432-684-6986
Mailing Address - Fax:
Practice Address - Street 1:835 TOWER DR
Practice Address - Street 2:SUITE 9
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4237
Practice Address - Country:US
Practice Address - Phone:432-664-8136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13299101YP2500X
TX00317363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical