Provider Demographics
NPI:1821169418
Name:BISKNER, CYNTHIA MARY (LMFT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARY
Last Name:BISKNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17195 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1415
Mailing Address - Country:US
Mailing Address - Phone:574-277-0274
Mailing Address - Fax:574-271-7202
Practice Address - Street 1:17195 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1415
Practice Address - Country:US
Practice Address - Phone:742-770-2745
Practice Address - Fax:574-271-7202
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
IN35001627A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000500774OtherANTHEM
IN200475040Medicaid