Provider Demographics
NPI:1861956799
Name:CYNTHIA D. RUDICK, PH.D, LPCC-S & CO., LLC
Entity type:Organization
Organization Name:CYNTHIA D. RUDICK, PH.D, LPCC-S & CO., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUDICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPCC-S
Authorized Official - Phone:330-492-2266
Mailing Address - Street 1:4765 HIGBEE AVE NW STE 6B
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2551
Mailing Address - Country:US
Mailing Address - Phone:330-492-2266
Mailing Address - Fax:
Practice Address - Street 1:4765 HIGBEE AVE NW STE 6B
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2551
Practice Address - Country:US
Practice Address - Phone:330-492-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty