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Individual

CYNTHIA ALLISON HOUSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED CAGS LCSW LMFT

Contact information

Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 339-8109
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 339-8109

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
39000925A
IN
101YM0800X
Mental Health Counselor
39000925A
IN
1041C0700X
Clinical Social Worker
Primary
34002414A
IN
106H00000X
Marriage & Family Therapist
35000944A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000074890
ANTHEM
Enumeration date
12/16/2005
Last updated
04/29/2009
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