Provider Demographics
NPI:1962520601
Name:MARZETTE, CYNTHIA MARIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIA
Last Name:MARZETTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N OPLAINE RD UNIT 8621
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-0869
Mailing Address - Country:US
Mailing Address - Phone:479-313-4794
Mailing Address - Fax:847-672-8714
Practice Address - Street 1:800 MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1578
Practice Address - Country:US
Practice Address - Phone:847-903-5604
Practice Address - Fax:847-867-7924
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4834-C1041C0700X
IL149.0155821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical