Active NPI
Cynthia D Eis, LPC
- Professional Counselor
- Prescott, AZ
National Provider Identifier
1679061410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17068
- Practice address
- 510 E Moeller St
Prescott, AZ 86301-2612 - Phone
- (928) 925-9477
- NPI assigned
- Apr 26, 2018
- 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 | 17068 | AZ | Primary |
Addresses
Primary practice location
510 E Moeller St
Prescott, AZ 86301-2612
Mailing address
510 E Moeller St
Prescott, AZ 86301-2612
Phone (928) 925-8535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 7, 2026 through May 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17068 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1679061410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 E MOELLER ST",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863012612",
"telephone_number": "928-925-8535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 E MOELLER ST",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863012612",
"telephone_number": "928-925-9477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EIS",
"first_name": "CYNTHIA",
"middle_name": "D",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-26",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "17068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.