Provider Demographics
NPI:1518267434
Name:MANNINO, CYNTHIA PEARL (MSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:PEARL
Last Name:MANNINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:MANNINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:2820 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5708
Practice Address - Country:US
Practice Address - Phone:810-600-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010890671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical