Provider Demographics
NPI:1720029432
Name:HAZELTON, CYNTHIA LEE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LEE
Last Name:HAZELTON
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 1:39 BENNETT HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1305
Mailing Address - Country:US
Mailing Address - Phone:978-948-3616
Mailing Address - Fax:
Practice Address - Street 1:174 HIGH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1220
Practice Address - Country:US
Practice Address - Phone:978-948-3600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health