Provider Demographics
NPI:1962567636
Name:HALE, CYNTHIA ANNE (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANNE
Last Name:HALE
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1287
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93014-1287
Mailing Address - Country:US
Mailing Address - Phone:805-509-3095
Mailing Address - Fax:
Practice Address - Street 1:4306 VERANO ST
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-1213
Practice Address - Country:US
Practice Address - Phone:805-585-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 221651041C0700X
NYR038084-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical