Provider Demographics
NPI:1740319649
Name:CHALFANT, CYNTHIA L (LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:CHALFANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CINDI
Other - Middle Name:L
Other - Last Name:CHALFANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 6011
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-6011
Mailing Address - Country:US
Mailing Address - Phone:573-220-2983
Mailing Address - Fax:573-642-3440
Practice Address - Street 1:2625 FAIRWAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-3936
Practice Address - Country:US
Practice Address - Phone:573-220-2983
Practice Address - Fax:573-642-3440
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional