Provider Demographics
NPI:1518289826
Name:TASKA, CYNTHIA WARREN (MSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:WARREN
Last Name:TASKA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:DEERING
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1926 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:VT
Mailing Address - Zip Code:05847-9647
Mailing Address - Country:US
Mailing Address - Phone:802-744-6163
Mailing Address - Fax:
Practice Address - Street 1:1926 VALLEY RD
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:VT
Practice Address - Zip Code:05847-9647
Practice Address - Country:US
Practice Address - Phone:802-744-6163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.00628311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical