Provider Demographics
NPI:1669776944
Name:PAHLKOTTER, CYNTHIA E (BS, MA, LLPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:PAHLKOTTER
Suffix:
Gender:F
Credentials:BS, MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 CLEO ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1437
Mailing Address - Country:US
Mailing Address - Phone:517-803-1302
Mailing Address - Fax:
Practice Address - Street 1:1019 CLEO ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1437
Practice Address - Country:US
Practice Address - Phone:517-803-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010768101YP2500X
MI227493101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool