Provider Demographics
NPI:1508030438
Name:DODERO, CYNTHIA (LPC, NCC, BCPC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:DODERO
Suffix:
Gender:F
Credentials:LPC, NCC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39109 HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-5517
Mailing Address - Country:US
Mailing Address - Phone:248-835-2466
Mailing Address - Fax:
Practice Address - Street 1:39109 HELENA AVE
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-5517
Practice Address - Country:US
Practice Address - Phone:586-335-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional