Active NPI
Cynthia Sue Dodge, PH.D.
- Psychologist
- Henderson, NV
National Provider Identifier
1376817577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 393
- Practice address
- 2579 Thatcher Ave
Henderson, NV 89052-6916 - Phone
- (510) 965-8394
- NPI assigned
- Mar 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 393 | AK | Primary |
Addresses
Primary practice location
2579 Thatcher Ave
Henderson, NV 89052-6916
Mailing address
2579 Thatcher Ave
Henderson, NV 89052-6916
Phone (510) 965-8394
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 393 | AK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330992000000",
"number": "1376817577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2579 THATCHER AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890526916",
"telephone_number": "510-965-8394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2579 THATCHER AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890526916",
"telephone_number": "510-965-8394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "CYNTHIA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-06",
"last_updated": "2012-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AK",
"license": "393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.