Provider Demographics
NPI:1568590727
Name:MONROE, CYNTHIA NICHOLS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:NICHOLS
Last Name:MONROE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:CAROL
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:2150 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38127-6662
Mailing Address - Country:US
Mailing Address - Phone:901-353-5440
Mailing Address - Fax:901-353-5464
Practice Address - Street 1:2150 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-6662
Practice Address - Country:US
Practice Address - Phone:901-353-5440
Practice Address - Fax:901-353-5464
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical