Provider Demographics
NPI:1154519528
Name:MALEK, CYNTHIA RENE (LCSW-R, CASAC)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:RENE
Last Name:MALEK
Suffix:
Gender:F
Credentials:LCSW-R, CASAC
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:RENE
Other - Last Name:MALEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R, CASAC
Mailing Address - Street 1:719 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2695
Mailing Address - Country:US
Mailing Address - Phone:315-464-3265
Mailing Address - Fax:315-464-3282
Practice Address - Street 1:600 E GENESEE ST STE 217
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3108
Practice Address - Country:US
Practice Address - Phone:315-463-3265
Practice Address - Fax:315-464-3282
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NYR082979-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical