Basic Information
| Provider Information | |||||||||
| NPI: | 1033557962 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEREDITH | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2271 HODGENVILLE RD | ||||||||
| Address2: | |||||||||
| City: | ELIZABETHTOWN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427018145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702346139 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2272 HODGENVILLE ROAD | ||||||||
| Address2: | |||||||||
| City: | ELIZABETHTOWN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2702346139 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2013 | ||||||||
| LastUpdateDate: | 08/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 1714 | KY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.