Provider Demographics
NPI:1124319769
Name:GUY, CYNTHIA (LICENSE SOCIAL WORKE)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:LICENSE SOCIAL WORKE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11135 173RD ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-4006
Mailing Address - Country:US
Mailing Address - Phone:718-291-6371
Mailing Address - Fax:
Practice Address - Street 1:8974 162ND ST FL 5
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5072
Practice Address - Country:US
Practice Address - Phone:718-471-6818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-01
Last Update Date:2011-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0710941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical