Provider Demographics
NPI:1841899986
Name:HRDLICHKA, CYNTHIA (LPC P2306026)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HRDLICHKA
Suffix:
Gender:F
Credentials:LPC P2306026
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N ROCKCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-3814
Mailing Address - Country:US
Mailing Address - Phone:501-232-3058
Mailing Address - Fax:
Practice Address - Street 1:221 N EAST AVE STE 104
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5226
Practice Address - Country:US
Practice Address - Phone:479-549-7295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2306026101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health