Provider Demographics
NPI:1134289192
Name:BELL, CYNTHIA ANN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANN
Last Name:BELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:18 LYMAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1459
Mailing Address - Country:US
Mailing Address - Phone:508-366-6388
Mailing Address - Fax:508-429-6668
Practice Address - Street 1:18 LYMAN ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1459
Practice Address - Country:US
Practice Address - Phone:508-366-6388
Practice Address - Fax:508-429-6668
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1061701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABEP04113Medicare ID - Type Unspecified
MAP04113Medicare UPIN