Provider Demographics
NPI:1598323933
Name:MORTON, CYNTHIA LENOR (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LENOR
Last Name:MORTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LENOR
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDS, LPC, NCC
Mailing Address - Street 1:2331 HIWASSEE DR.
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:30252
Mailing Address - Country:US
Mailing Address - Phone:678-920-3357
Mailing Address - Fax:
Practice Address - Street 1:1000 CORPORATE POINTE STE 117
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-3440
Practice Address - Country:US
Practice Address - Phone:678-920-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional