Provider Demographics
NPI:1003098450
Name:JOSEPH, CYNTHIA A (MSW,LMSW,CAAC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MSW,LMSW,CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4236
Mailing Address - Country:US
Mailing Address - Phone:989-793-2515
Mailing Address - Fax:989-793-2517
Practice Address - Street 1:120 N MICHIGAN AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4236
Practice Address - Country:US
Practice Address - Phone:989-793-2515
Practice Address - Fax:989-793-2517
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010722511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI257178OtherCOMPSYCH