Provider Demographics
NPI:1538146881
Name:BUFF, CYNTHIA SUSAN (PHD LCSW LCAS RN)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:SUSAN
Last Name:BUFF
Suffix:
Gender:F
Credentials:PHD LCSW LCAS RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BREVARD RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2922
Mailing Address - Country:US
Mailing Address - Phone:828-253-0778
Mailing Address - Fax:828-252-3774
Practice Address - Street 1:107 BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2922
Practice Address - Country:US
Practice Address - Phone:828-253-0778
Practice Address - Fax:828-252-3774
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC591101YA0400X
NCC0004261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002195Medicaid
NC2861063Medicare ID - Type Unspecified