Provider Demographics
NPI:1225200488
Name:CYNTHIA PICKETT, MSW, LCSW, LADC, INC.
Entity Type:Organization
Organization Name:CYNTHIA PICKETT, MSW, LCSW, LADC, INC.
Other - Org Name:CYNTHIA PICKETT, MSW, LCSW, LADC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:775-322-6462
Mailing Address - Street 1:316 CALIFORNIA AVE
Mailing Address - Street 2:#134
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-1650
Mailing Address - Country:US
Mailing Address - Phone:775-322-6462
Mailing Address - Fax:
Practice Address - Street 1:401 COURT ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1708
Practice Address - Country:US
Practice Address - Phone:775-322-6462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4062-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty