Provider Demographics
NPI:1740611953
Name:FINNEY, CYNTHIA G (LAC, ICAADC, ICCDP,)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:G
Last Name:FINNEY
Suffix:
Gender:F
Credentials:LAC, ICAADC, ICCDP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 WESTERN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619
Mailing Address - Country:US
Mailing Address - Phone:574-233-1524
Mailing Address - Fax:574-233-1612
Practice Address - Street 1:4218 WESTERN AVENUE
Practice Address - Street 2:
Practice Address - City:SO BEND
Practice Address - State:IN
Practice Address - Zip Code:46619
Practice Address - Country:US
Practice Address - Phone:574-233-1524
Practice Address - Fax:574-233-1612
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000353A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)