Provider Demographics
NPI:1013041995
Name:BEHM, CYNTHIA J (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:J
Last Name:BEHM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8845 OLD STAGECOACH RD
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4933
Mailing Address - Country:US
Mailing Address - Phone:301-932-0323
Mailing Address - Fax:301-753-4991
Practice Address - Street 1:616 EAST CHARLES STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646
Practice Address - Country:US
Practice Address - Phone:301-753-8306
Practice Address - Fax:301-753-4991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK103OtherBLUECROSS BLUESHIELD
MD212554OtherUNITED HEALTHCARE
MD331053OtherMHN
MD732251-0000OtherAETNA