Provider Demographics
NPI:1407192511
Name:CHESTNUT, CYNTHIA (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HOGAN CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9367
Mailing Address - Country:US
Mailing Address - Phone:302-373-7312
Mailing Address - Fax:
Practice Address - Street 1:4 HOGAN CIR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9367
Practice Address - Country:US
Practice Address - Phone:302-373-7312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFT-0000025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist