Provider Demographics
NPI:1477808582
Name:TREVINO BURNS, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:TREVINO BURNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ELAINE
Other - Last Name:TREVINO BURNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1000 CAMELOT DR APT 6076
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8405
Mailing Address - Country:US
Mailing Address - Phone:956-341-1017
Mailing Address - Fax:
Practice Address - Street 1:401 E FILMORE AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6904
Practice Address - Country:US
Practice Address - Phone:956-341-1017
Practice Address - Fax:210-247-9611
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202131041C0700X, 251B00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX315776OtherTEXAS MEDICARE NUMBER
TX311202102Medicaid