Provider Demographics
NPI:1003942285
Name:BEJSTER, CYNTHIA R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:R
Last Name:BEJSTER
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 1:3903 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-2555
Mailing Address - Country:US
Mailing Address - Phone:219-392-6065
Mailing Address - Fax:219-392-6998
Practice Address - Street 1:3903 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-2555
Practice Address - Country:US
Practice Address - Phone:219-392-6065
Practice Address - Fax:219-392-6998
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005038A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200275200AMedicaid
IN200275200AMedicaid