Provider Demographics
NPI:1508180365
Name:HAUPT, CYNTHIA LEIGH (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LEIGH
Last Name:HAUPT
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:CROSS RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10518-0421
Mailing Address - Country:US
Mailing Address - Phone:914-763-0868
Mailing Address - Fax:914-763-0868
Practice Address - Street 1:892 ROUTE 35
Practice Address - Street 2:
Practice Address - City:CROSS RIVER
Practice Address - State:NY
Practice Address - Zip Code:10518-1141
Practice Address - Country:US
Practice Address - Phone:914-763-0868
Practice Address - Fax:914-763-0868
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
NYR042147-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist