Provider Demographics
NPI:1780761767
Name:WHITAKER, CYNTHIA LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PROSPECT ST.
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-883-1568
Practice Address - Street 1:100 WEST PEARL ST.
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-882-2017
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH1155103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist