Provider Demographics
NPI:1558025742
Name:ROBERTSON, CYNTHIA (LCSW-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:RATLIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2012 S TOLLGATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5902
Mailing Address - Country:US
Mailing Address - Phone:443-591-9945
Mailing Address - Fax:
Practice Address - Street 1:3463 LOGANVIEW DR
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-5950
Practice Address - Country:US
Practice Address - Phone:443-891-6957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD265761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical