Provider Demographics
NPI:1063519601
Name:BARNWELL, CYNTHIA (LMSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BARNWELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1100
Mailing Address - Country:US
Mailing Address - Phone:734-996-8149
Mailing Address - Fax:
Practice Address - Street 1:409 PLYMOUTH RD
Practice Address - Street 2:STE 190
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1493
Practice Address - Country:US
Practice Address - Phone:734-454-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010603801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical