Provider Demographics
NPI:1376856484
Name:ADELL, CYNT. C (MSW)
Entity Type:Individual
Prefix:MS
First Name:CYNT.
Middle Name:C
Last Name:ADELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:DR
Other - First Name:CYNT.
Other - Middle Name:C
Other - Last Name:ADELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD
Mailing Address - Street 1:PO BOX 11275
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-0275
Mailing Address - Country:US
Mailing Address - Phone:414-236-5103
Mailing Address - Fax:
Practice Address - Street 1:7050 N PRESIDIO DR APT L
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6320
Practice Address - Country:US
Practice Address - Phone:414-236-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15955-132101YA0400X
FLADC-002019-2014101YA0400X
WI127338-121104100000X
DC8865384571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical