Active NPI
Cynthia A Niedbalski, LPC
- Professional Counselor
- O'Fallon, MO
National Provider Identifier
1518090208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2000150932
- Practice address
- 214 Church St
O Fallon, MO 63366-2814 - Phone
- (314) 706-9493
- Fax
- (636) 240-0261
- NPI assigned
- Mar 13, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2000150932 | MO | Primary |
Addresses
Primary practice location
214 Church St
O Fallon, MO 63366-2814
Mailing address
38 Fox Hollow Dr
Saint Charles, MO 63304-7626
Phone (636) 240-0523
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 372818 | Other | MO | MENTAL HEALTH NETWORK |
| 173405 | Other | MO | ANTHEM BLUE CROSS |
| 11567580 | Other | MO | CAQH |
| 479705 | Other | MO | VALUE OPTIONS |
Other names 1
- Miss Cynthia Ann Sifford
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000150932 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518090208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 FOX HOLLOW DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633047626",
"telephone_number": "636-240-0523",
"fax_number": "636-240-0261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 CHURCH ST",
"city": "O FALLON",
"state": "MO",
"postal_code": "633662814",
"telephone_number": "314-706-9493",
"fax_number": "636-240-0261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEDBALSKI",
"first_name": "CYNTHIA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2000150932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH NETWORK",
"identifier": "372818",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "173405",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11567580",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "479705",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CYNTHIA",
"last_name": "SIFFORD",
"middle_name": "ANN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in O'Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.