Provider Demographics
NPI:1568519304
Name:LEVY, CYNTHIA M (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:LEVY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 HAHN PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-7324
Mailing Address - Country:US
Mailing Address - Phone:757-877-1995
Mailing Address - Fax:
Practice Address - Street 1:1657 MERRIMAC TRL
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5624
Practice Address - Country:US
Practice Address - Phone:757-220-3200
Practice Address - Fax:757-253-4371
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA052707OtherVALUE OPTIONS
VAOPTIMAOtherO82143
VA254536000OtherMAGELLAN
VA320421OtherANTHEM
VAANTHEMOther320422
VA004945301Medicaid
VA323457OtherMANAGED HEALTH NET