Provider Demographics
NPI:1235295312
Name:HOLSHOE, CYNTHIA GIBSON (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:GIBSON
Last Name:HOLSHOE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 UPLAND WAY
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2326
Mailing Address - Country:US
Mailing Address - Phone:401-289-2232
Mailing Address - Fax:401-289-2120
Practice Address - Street 1:1060 GAFFNEY RD FL 74402
Practice Address - Street 2:
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703
Practice Address - Country:US
Practice Address - Phone:907-361-5603
Practice Address - Fax:907-361-4847
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
RIISW018061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical