Provider Demographics
NPI:1477259489
Name:WELLS, CYNTHIA DENISE (MFT, LMHC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISE
Last Name:WELLS
Suffix:
Gender:F
Credentials:MFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 LANGLEY AVE STE 4003000
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4700
Mailing Address - Country:US
Mailing Address - Phone:850-816-0414
Mailing Address - Fax:
Practice Address - Street 1:3000 LANGLEY AVE SUITE 400
Practice Address - Street 2:3000 LANGLEY AVE SUITE 400
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-816-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health