Provider Demographics
NPI:1528651932
Name:RYAN, CYNTHIA J (MSW, LSW, HSV)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:RYAN
Suffix:
Gender:F
Credentials:MSW, LSW, HSV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-3031
Mailing Address - Country:US
Mailing Address - Phone:570-764-2636
Mailing Address - Fax:
Practice Address - Street 1:1083 BLOOM RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-6789
Practice Address - Country:US
Practice Address - Phone:570-764-2636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW013207L1041S0200X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool