Provider Demographics
NPI:1982278214
Name:ELLIS, CYNTHIA (BEHAVIOR ANALYST)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ELLIS
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 POWERS AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36205-4419
Mailing Address - Country:US
Mailing Address - Phone:256-847-5942
Mailing Address - Fax:334-323-6103
Practice Address - Street 1:664 POWERS AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205-4419
Practice Address - Country:US
Practice Address - Phone:256-847-5942
Practice Address - Fax:334-323-6103
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2025-129103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst