Provider Demographics
NPI:1336331784
Name:SAX, CYNTHY ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:CYNTHY
Middle Name:ANN
Last Name:SAX
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CYNTHY
Other - Middle Name:
Other - Last Name:SAX-ROMNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 BROADWAY BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2360
Mailing Address - Country:US
Mailing Address - Phone:505-345-8471
Mailing Address - Fax:
Practice Address - Street 1:707 BROADWAY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2360
Practice Address - Country:US
Practice Address - Phone:505-345-8471
Practice Address - Fax:505-342-5980
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM3995104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker