Provider Demographics
NPI:1376600015
Name:PRINCE, CYNTHIA D (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:PRINCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 QUINCY AVE
Mailing Address - Street 2:#2
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3147
Mailing Address - Country:US
Mailing Address - Phone:508-740-1558
Mailing Address - Fax:
Practice Address - Street 1:103 WINTER ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3306
Practice Address - Country:US
Practice Address - Phone:781-769-1568
Practice Address - Fax:781-769-4722
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2138291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical