Provider Demographics
NPI:1457843260
Name:CYNERGY CARE AND COUNSELING
Entity Type:Organization
Organization Name:CYNERGY CARE AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSUMER DIRECT SERVICE FACILITATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:HOLMES
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MS PSY/COUNSELING
Authorized Official - Phone:540-373-0957
Mailing Address - Street 1:1205 GRAHAM DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-2687
Mailing Address - Country:US
Mailing Address - Phone:540-373-0957
Mailing Address - Fax:540-373-0957
Practice Address - Street 1:1205 GRAHAM DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-2687
Practice Address - Country:US
Practice Address - Phone:540-373-0957
Practice Address - Fax:540-373-0957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0610652452Medicaid