Provider Demographics
NPI:1235478629
Name:CHALKER, CYNTHIA (LMSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CHALKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 RIVERSIDE DR APT 14C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3440
Mailing Address - Country:US
Mailing Address - Phone:917-796-6222
Mailing Address - Fax:
Practice Address - Street 1:245 E 13TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5641
Practice Address - Country:US
Practice Address - Phone:917-796-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086674-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker