Provider Demographics
NPI:1205082765
Name:BRUMBAUGH, CINDY LEE (LSW CAC)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LEE
Last Name:BRUMBAUGH
Suffix:
Gender:F
Credentials:LSW CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W HIGH ST
Mailing Address - Street 2:THE LOFTS AT SPRING CREEK LOFT # 10
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1301
Mailing Address - Country:US
Mailing Address - Phone:814-571-2452
Mailing Address - Fax:
Practice Address - Street 1:219 W HIGH ST
Practice Address - Street 2:THE LOFTS AT SPRING CREEK LOFT # 10
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1301
Practice Address - Country:US
Practice Address - Phone:814-571-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5410101YA0400X
PASW126527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5410OtherCERTIFIED ADDICTION COUNSELOR