Provider Demographics
NPI:1609868629
Name:WARD, CYNTHIA MARIE (LCSW BCD)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW BCD
Mailing Address - Street 1:29645 RANCHO CALIFORNIA RD.
Mailing Address - Street 2:SUITE 238
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5211
Mailing Address - Country:US
Mailing Address - Phone:951-587-2222
Mailing Address - Fax:951-693-1010
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD.
Practice Address - Street 2:SUITE 238
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5211
Practice Address - Country:US
Practice Address - Phone:951-587-2222
Practice Address - Fax:951-693-1010
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 85241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609868629OtherPROVIDER NPI
CA1609868629OtherPROVIDER NPI