Provider Demographics
NPI:1013114941
Name:SMITH, CINDY B (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:B
Last Name:SMITH
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 1:1728 S CARSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4610
Mailing Address - Country:US
Mailing Address - Phone:918-816-1149
Mailing Address - Fax:918-280-0310
Practice Address - Street 1:1728 S CARSON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4610
Practice Address - Country:US
Practice Address - Phone:918-816-1149
Practice Address - Fax:918-280-0310
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5282101YM0800X
MS LPC UNDER SUP.101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health