Provider Demographics
NPI:1407042088
Name:MESMER, CYNTHIA LYNN (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:MESMER
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PYOTT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8716
Mailing Address - Country:US
Mailing Address - Phone:815-444-9076
Mailing Address - Fax:815-444-9079
Practice Address - Street 1:900 PYOTT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8716
Practice Address - Country:US
Practice Address - Phone:815-444-9076
Practice Address - Fax:815-444-9079
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional