Provider Demographics
NPI:1871678813
Name:NICOLINI, CYNTHIA (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:NICOLINI
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 PINE RIDGE FISHERS LANDING
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520
Mailing Address - Country:US
Mailing Address - Phone:713-252-4801
Mailing Address - Fax:
Practice Address - Street 1:9529 N HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77520-9600
Practice Address - Country:US
Practice Address - Phone:713-252-4801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002392-042342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional