Provider Demographics
NPI:1083854178
Name:FECCHIA, CYNTHIA M (SW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:FECCHIA
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SW CLAY ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1436
Mailing Address - Country:US
Mailing Address - Phone:785-845-7349
Mailing Address - Fax:855-609-1049
Practice Address - Street 1:4105 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4609
Practice Address - Country:US
Practice Address - Phone:785-727-0977
Practice Address - Fax:855-609-1049
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical