Provider Demographics
NPI:1881376820
Name:HIMSTEDT, CYNTHIA (LPC-S, CSC, M ED)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HIMSTEDT
Suffix:
Gender:F
Credentials:LPC-S, CSC, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BRIARCREST DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-6379
Mailing Address - Country:US
Mailing Address - Phone:210-445-0592
Mailing Address - Fax:
Practice Address - Street 1:2625 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-6379
Practice Address - Country:US
Practice Address - Phone:210-445-0592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60846101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional