Provider Demographics
NPI:1376632885
Name:HOLLISTER, CYNTHIA G (MSW LMHP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:G
Last Name:HOLLISTER
Suffix:
Gender:F
Credentials:MSW LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S 16TH ST
Mailing Address - Street 2:ATTN COUNSELING CENTER
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502
Mailing Address - Country:US
Mailing Address - Phone:402-481-4926
Mailing Address - Fax:402-481-4801
Practice Address - Street 1:2300 S 16TH ST
Practice Address - Street 2:ATTN COUNSELING CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502
Practice Address - Country:US
Practice Address - Phone:402-481-4926
Practice Address - Fax:402-481-4801
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1677101YM0800X
NE8421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical