Provider Demographics
NPI:1548099716
Name:CYNTHIA DAVIS DUPREE LLC
Entity type:Organization
Organization Name:CYNTHIA DAVIS DUPREE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:SAP M ED ICAADC LCAS
Authorized Official - Phone:757-790-7906
Mailing Address - Street 1:PO BOX 1952
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23327-1952
Mailing Address - Country:US
Mailing Address - Phone:757-790-7906
Mailing Address - Fax:
Practice Address - Street 1:748 APPALACHIAN CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1623
Practice Address - Country:US
Practice Address - Phone:757-790-7906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty