Provider Demographics
NPI:1710158399
Name:GILMER, CYNTHIA S (LCDC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:S
Last Name:GILMER
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 ABRAMS
Mailing Address - Street 2:STE 240
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081
Mailing Address - Country:US
Mailing Address - Phone:972-497-9040
Mailing Address - Fax:972-644-9376
Practice Address - Street 1:1219 ABRAMS
Practice Address - Street 2:STE 240
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75040
Practice Address - Country:US
Practice Address - Phone:972-497-9040
Practice Address - Fax:972-644-9376
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7518101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health