Provider Demographics
NPI:1013615129
Name:HIESTER, CYNTHIA LEA (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEA
Last Name:HIESTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:LEA
Other - Last Name:HIESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:500 THROCKMORTON ST APT 1208
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3710
Mailing Address - Country:US
Mailing Address - Phone:830-928-5441
Mailing Address - Fax:
Practice Address - Street 1:500 THROCKMORTON ST APT 1208
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3710
Practice Address - Country:US
Practice Address - Phone:830-928-5441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86479101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional