Provider Demographics
NPI:1104902246
Name:ELSWICK, CYNTHIA TAPP (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:TAPP
Last Name:ELSWICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 WOLFSNARE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3422
Mailing Address - Country:US
Mailing Address - Phone:757-425-5035
Mailing Address - Fax:
Practice Address - Street 1:3432 MAGIC HOLLOW BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:VA. BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453
Practice Address - Country:US
Practice Address - Phone:757-385-4279
Practice Address - Fax:757-468-2458
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861562472Medicaid