Provider Demographics
NPI:1639369739
Name:LEVY, CYNTHIA ALYSE (MA, BA)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ALYSE
Last Name:LEVY
Suffix:
Gender:F
Credentials:MA, BA
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:ALYSE
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, BA
Mailing Address - Street 1:2772 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6206
Mailing Address - Country:US
Mailing Address - Phone:619-295-6067
Mailing Address - Fax:
Practice Address - Street 1:2772 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6206
Practice Address - Country:US
Practice Address - Phone:619-295-6067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health