Provider Demographics
NPI:1821006156
Name:VANKEUREN, CYNTHIA P (PSY D)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:P
Last Name:VANKEUREN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24400 HIGHPOINT RD
Mailing Address - Street 2:STE # 6
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-6550
Mailing Address - Fax:216-831-6133
Practice Address - Street 1:24400 HIGHPOINT RD
Practice Address - Street 2:STE # 6
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-831-6550
Practice Address - Fax:216-831-6133
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH61042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH343179OtherVALUE OPTINA
OH24868000OtherMAGELLAN
OH24868000OtherMAGELLAN