Provider Demographics
NPI:1013563717
Name:PERRY, CYNTHIA A (COUNSELOR, MS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:PERRY
Suffix:
Gender:F
Credentials:COUNSELOR, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1324
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-1324
Mailing Address - Country:US
Mailing Address - Phone:888-355-7080
Mailing Address - Fax:256-615-8632
Practice Address - Street 1:104 BRICKSTONE PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-3498
Practice Address - Country:US
Practice Address - Phone:256-867-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-18
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL235540Medicaid