Provider Demographics
NPI:1982766887
Name:HEALEY, CYNTHIA VALENTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:VALENTINE
Last Name:HEALEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:VALENTINE
Other - Last Name:HEYWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3575 DONALD ST
Mailing Address - Street 2:150
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4753
Mailing Address - Country:US
Mailing Address - Phone:541-505-4997
Mailing Address - Fax:
Practice Address - Street 1:3575 DONALD ST
Practice Address - Street 2:#150
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4753
Practice Address - Country:US
Practice Address - Phone:541-505-4997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2346103TC0700X, 103TC2200X
103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool