Provider Demographics
NPI:1194441030
Name:MARSH, CYNTHIA ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANNE
Last Name:MARSH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 CLAYTON RD STE 303
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1341
Mailing Address - Country:US
Mailing Address - Phone:785-737-3096
Mailing Address - Fax:
Practice Address - Street 1:7750 CLAYTON RD STE 303
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1341
Practice Address - Country:US
Practice Address - Phone:785-737-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220406041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical