Provider Demographics
NPI:1801384904
Name:LOWERY, CYNTHIA DENISE BERRY (LPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISE BERRY
Last Name:LOWERY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LOWERY
Other - Last Name:STAPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:414 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6409
Mailing Address - Country:US
Mailing Address - Phone:903-238-9050
Mailing Address - Fax:
Practice Address - Street 1:414 N GREEN ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-6409
Practice Address - Country:US
Practice Address - Phone:903-238-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional