Provider Demographics
NPI:1346415981
Name:DAVIS, CYNTHIA K (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:K
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 ROSE HILL DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-293-6453
Mailing Address - Fax:434-220-3335
Practice Address - Street 1:1110 ROSE HILL DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-293-6453
Practice Address - Fax:434-220-3335
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7031356OtherAETNA
VA238595OtherANTHEM
VA010303672Medicaid
VA083496OtherSENTARA