Provider Demographics
NPI:1659530848
Name:WHITTEN, CYNDE A (LPC, LADC)
Entity Type:Individual
Prefix:
First Name:CYNDE
Middle Name:A
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23280 266TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-4615
Mailing Address - Country:US
Mailing Address - Phone:405-236-1822
Mailing Address - Fax:405-288-0471
Practice Address - Street 1:23280 266TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:OK
Practice Address - Zip Code:73093-4615
Practice Address - Country:US
Practice Address - Phone:405-236-1822
Practice Address - Fax:405-288-0471
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK20077440AMedicaid
OK20077440AMedicaid