Provider Demographics
NPI:1134550106
Name:LEON, CYNTHIA REESE (MA, LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:REESE
Last Name:LEON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LYNN REESE
Other - Last Name:PURYEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 EMORY OAK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2812
Mailing Address - Country:US
Mailing Address - Phone:512-406-1484
Mailing Address - Fax:
Practice Address - Street 1:7 EMORY OAK CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77381-2812
Practice Address - Country:US
Practice Address - Phone:512-406-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67443101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3293813-01OtherTPI