Provider Demographics
NPI:1225275175
Name:GREENSPAN, CYNTHIA TITUS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:TITUS
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:LYNN
Other - Last Name:TITUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5276 DAWES AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1404
Mailing Address - Country:US
Mailing Address - Phone:703-379-7350
Mailing Address - Fax:703-379-7352
Practice Address - Street 1:5276 DAWES AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1404
Practice Address - Country:US
Practice Address - Phone:703-379-7350
Practice Address - Fax:703-379-7352
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040068591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1457403099Medicaid
VAG00909OtherMEDICARE GROUP