Provider Demographics
NPI:1790965937
Name:ROBERTS, CYNTHIA LEIGH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEIGH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1679 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4013
Mailing Address - Country:US
Mailing Address - Phone:541-915-8712
Mailing Address - Fax:
Practice Address - Street 1:1679 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4013
Practice Address - Country:US
Practice Address - Phone:541-915-8712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health