Provider Demographics
NPI:1265181648
Name:CYNTHIA STAVA COUNSELING INC.
Entity type:Organization
Organization Name:CYNTHIA STAVA COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:STAVA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:562-547-3833
Mailing Address - Street 1:41447 PRINCEVILLE LN # 1018
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-7956
Mailing Address - Country:US
Mailing Address - Phone:562-547-3383
Mailing Address - Fax:
Practice Address - Street 1:72925 FRED WARING DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-9405
Practice Address - Country:US
Practice Address - Phone:562-547-3383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty