Provider Demographics
NPI:1093219016
Name:BORZOK, CYNTHIA BROWN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:BROWN
Last Name:BORZOK
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 1:1 SHUMWAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-6811
Mailing Address - Country:US
Mailing Address - Phone:570-439-3398
Mailing Address - Fax:
Practice Address - Street 1:63 3RD ST STE 103
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:PA
Practice Address - Zip Code:16933-1262
Practice Address - Country:US
Practice Address - Phone:570-662-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0157021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical