Provider Demographics
NPI:1952426686
Name:STOBER, CYNTHIA (LCMHC,LCAS, LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:STOBER
Suffix:
Gender:F
Credentials:LCMHC,LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20180 SE 43RD ST
Mailing Address - Street 2:
Mailing Address - City:HARRAH
Mailing Address - State:OK
Mailing Address - Zip Code:73045-6147
Mailing Address - Country:US
Mailing Address - Phone:919-798-3262
Mailing Address - Fax:
Practice Address - Street 1:20180 SE 43RD ST
Practice Address - Street 2:
Practice Address - City:HARRAH
Practice Address - State:OK
Practice Address - Zip Code:73045-6147
Practice Address - Country:US
Practice Address - Phone:919-798-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14758101YM0800X, 101YP2500X
OK4247101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14758OtherLPC
NC25470OtherLCAS