Provider Demographics
NPI:1649658675
Name:KINNEY, CYNTHIA BISLAND (MSCP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:BISLAND
Last Name:KINNEY
Suffix:
Gender:F
Credentials:MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 INGOMAR RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9509
Mailing Address - Country:US
Mailing Address - Phone:412-364-9071
Mailing Address - Fax:
Practice Address - Street 1:8400 PERRY HWY STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5235
Practice Address - Country:US
Practice Address - Phone:412-364-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional