Provider Demographics
NPI:1457888141
Name:SEE, CYNTHA SUSANNE (CADC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHA
Middle Name:SUSANNE
Last Name:SEE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:SEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501
Mailing Address - Country:US
Mailing Address - Phone:641-683-6747
Mailing Address - Fax:641-683-6317
Practice Address - Street 1:111 NORTH MAIN
Practice Address - Street 2:SUITE 2
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544
Practice Address - Country:US
Practice Address - Phone:641-856-3112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06114101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)