Provider Demographics
NPI:1376919175
Name:PENN, CINDY LYNN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LYNN
Last Name:PENN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 PELHAM RD # 241
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5044
Mailing Address - Country:US
Mailing Address - Phone:864-201-2628
Mailing Address - Fax:
Practice Address - Street 1:3620 PELHAM RD # 241
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5044
Practice Address - Country:US
Practice Address - Phone:864-201-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4550106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist