Provider Demographics
NPI:1316346067
Name:VORDENBAUM, CID (LCSW)
Entity type:Individual
Prefix:
First Name:CID
Middle Name:
Last Name:VORDENBAUM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LOU
Other - Last Name:VORDENBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:179 REHOBOTH AVE UNIT 85
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-7904
Mailing Address - Country:US
Mailing Address - Phone:202-701-3831
Mailing Address - Fax:
Practice Address - Street 1:1632 SAVANNAH RD
Practice Address - Street 2:UNIT 5
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1659
Practice Address - Country:US
Practice Address - Phone:302-644-1224
Practice Address - Fax:302-827-4382
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00011621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical