Provider Demographics
NPI:1609280957
Name:SOMERS, CYNTHIA (BS, MBA, PHD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SOMERS
Suffix:
Gender:F
Credentials:BS, MBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4522 NW 48TH TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3619
Mailing Address - Country:US
Mailing Address - Phone:954-588-8303
Mailing Address - Fax:
Practice Address - Street 1:5420 NW 33RD AVE STE 6
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6387
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-15
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2891106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist