Provider Demographics
NPI:1891819124
Name:COUCH, CYNTHIA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:COUCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8582 KATY FWY
Mailing Address - Street 2:SUITE100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1830
Mailing Address - Country:US
Mailing Address - Phone:713-613-5200
Mailing Address - Fax:713-681-9089
Practice Address - Street 1:8582 KATY FWY
Practice Address - Street 2:SUITE100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1830
Practice Address - Country:US
Practice Address - Phone:713-613-5200
Practice Address - Fax:713-681-9089
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health