Provider Demographics
NPI:1083487326
Name:COLON, CYNTHIA MELIZZA (LMSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MELIZZA
Last Name:COLON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11215 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4508
Mailing Address - Country:US
Mailing Address - Phone:301-404-9440
Mailing Address - Fax:
Practice Address - Street 1:11215 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4508
Practice Address - Country:US
Practice Address - Phone:301-404-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26155104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker