Provider Demographics
NPI:1508917378
Name:MEESKE, CYNTHIA LYNNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNNE
Last Name:MEESKE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 MAIN ST STE 304
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1815
Mailing Address - Country:US
Mailing Address - Phone:774-573-1644
Mailing Address - Fax:774-233-0037
Practice Address - Street 1:89 MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1815
Practice Address - Country:US
Practice Address - Phone:774-573-1644
Practice Address - Fax:774-233-0037
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
113248104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker