Provider Demographics
NPI:1760722706
Name:UNGER, CYNTHIA A (MA, LPCC, LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:UNGER
Suffix:
Gender:F
Credentials:MA, LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 LAKE HAVASU AVE S STE F713
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-0938
Mailing Address - Country:US
Mailing Address - Phone:505-278-0552
Mailing Address - Fax:505-544-2593
Practice Address - Street 1:276 LAKE HAVASU AVE S STE A9-A
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-0851
Practice Address - Country:US
Practice Address - Phone:928-275-4144
Practice Address - Fax:505-544-2593
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0175441101YP2500X
NM0175441101YP2500X
AZLPC-19375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18853081Medicaid