Provider Demographics
NPI:1518307354
Name:WALDO, CYNTHIA ANN (PLMHP, PCMSW, MSW, M)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:WALDO
Suffix:
Gender:F
Credentials:PLMHP, PCMSW, MSW, M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15002 BLONDO ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-4150
Mailing Address - Country:US
Mailing Address - Phone:402-498-9000
Mailing Address - Fax:402-498-4475
Practice Address - Street 1:15002 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-4150
Practice Address - Country:US
Practice Address - Phone:402-498-9000
Practice Address - Fax:402-498-4475
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9809101YM0800X
NE68411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical