Provider Demographics
NPI:1629265244
Name:CORDERO-WALTON, CYNTHIA (LMHC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CORDERO-WALTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MIDSTATE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1856
Mailing Address - Country:US
Mailing Address - Phone:508-832-5800
Mailing Address - Fax:508-456-8253
Practice Address - Street 1:15 MIDSTATE DR STE 204
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-1856
Practice Address - Country:US
Practice Address - Phone:508-832-5800
Practice Address - Fax:508-456-8253
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health