Provider Demographics
NPI:1720607864
Name:NEWSOM, CYNTHIA DENEASE (LPC, DBTT, LCDC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENEASE
Last Name:NEWSOM
Suffix:
Gender:F
Credentials:LPC, DBTT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29202 MCKINNON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-9798
Mailing Address - Country:US
Mailing Address - Phone:832-729-9583
Mailing Address - Fax:281-346-2242
Practice Address - Street 1:29202 MCKINNON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-9798
Practice Address - Country:US
Practice Address - Phone:832-729-9583
Practice Address - Fax:281-346-2242
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty