Provider Demographics
NPI:1215051644
Name:DAANE, CYNTHIA F (MSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:DAANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:F
Other - Last Name:PRITZL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1012 FALLS PARC DR APT 9
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53085-3417
Mailing Address - Country:US
Mailing Address - Phone:920-627-3856
Mailing Address - Fax:
Practice Address - Street 1:2801 CALUMET DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083-3839
Practice Address - Country:US
Practice Address - Phone:920-451-6908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12584101YA0400X
WI216-123101YM0800X
WI211-1241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215051644Medicaid
WI000284282Medicare PIN