Provider Demographics
NPI:1669910634
Name:MAHY, CYNTHIA (LCDC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MAHY
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5711 LAVENDER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-1725
Mailing Address - Country:US
Mailing Address - Phone:713-557-8573
Mailing Address - Fax:832-328-5109
Practice Address - Street 1:5711 LAVENDER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1725
Practice Address - Country:US
Practice Address - Phone:713-557-8573
Practice Address - Fax:832-328-5109
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)