| Doctor Name: | CINDY JEAN MATHIESON |
| NPI Number: | 1053769505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC-C |
| License Number: | XL4275 |
| Business Practice Address: | 474 Main St Springvale, ME - 040831409 |
| Business Phone Number: | 2073241500 |
| Business Fax Number: | 2074905263 |
| Mailing Address: | 78 Atlantic Pl, SOUTH PORTLAND |
| State: | ME |
| Postal Code: | 041062316 |
| Phone Number: | 2076616654 |
| Fax Number: | 2078427773 |
| NPI Enumeration Date: | 05/25/2016 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | XL4275 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |