Provider Demographics
NPI:1902103088
Name:FORNES, CINDY (LSW)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:FORNES
Suffix:
Gender:
Credentials:LSW
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:FORNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:356 WHETHERSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-9639
Mailing Address - Country:US
Mailing Address - Phone:856-881-1926
Mailing Address - Fax:
Practice Address - Street 1:356 WHETHERSFIELD DR
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-9639
Practice Address - Country:US
Practice Address - Phone:856-881-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057950001041C0700X
NJ4SL05335200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker