Provider Demographics
NPI:1497871685
Name:MASSE, CYNTHIA F (MSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:F
Last Name:MASSE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:FREDRICKS
Other - Last Name:MASSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:172 E CUSHING ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2255
Mailing Address - Country:US
Mailing Address - Phone:401-274-1754
Mailing Address - Fax:
Practice Address - Street 1:172 E CUSHING ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2255
Practice Address - Country:US
Practice Address - Phone:401-274-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW009171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26630-1OtherBLUE CROSS
RI410756OtherBLUE CHIP