Provider Demographics
NPI:1639261076
Name:HODGE, CYNTHIA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAY
Last Name:HODGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:KAY
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:19 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2212
Mailing Address - Country:US
Mailing Address - Phone:717-263-7758
Mailing Address - Fax:717-261-1147
Practice Address - Street 1:19 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2212
Practice Address - Country:US
Practice Address - Phone:717-263-7758
Practice Address - Fax:717-261-1147
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0139201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical