Provider Demographics
NPI:1609339183
Name:HORNBAKER, CINDY JEANNE (LPC)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:JEANNE
Last Name:HORNBAKER
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 1:2 HERCULES DR
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28307-1511
Mailing Address - Country:US
Mailing Address - Phone:423-557-3862
Mailing Address - Fax:
Practice Address - Street 1:35 PLANTATION DR STE 100B
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-9430
Practice Address - Country:US
Practice Address - Phone:910-302-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional