Provider Demographics
NPI:1356494587
Name:CYNTHIA K. DAVIS, LCSW, PLC
Entity Type:Organization
Organization Name:CYNTHIA K. DAVIS, LCSW, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:434-293-6453
Mailing Address - Street 1:1110 ROSE HILL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5159
Mailing Address - Country:US
Mailing Address - Phone:434-293-6453
Mailing Address - Fax:434-220-3335
Practice Address - Street 1:1110 ROSE HILL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5159
Practice Address - Country:US
Practice Address - Phone:434-293-6453
Practice Address - Fax:434-220-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040030731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty