Provider Demographics
NPI:1689906232
Name:BERRY-HOLLOWAY, CYNTHIA ROCHELLE (LMSW-#016226-1 CASAC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ROCHELLE
Last Name:BERRY-HOLLOWAY
Suffix:
Gender:F
Credentials:LMSW-#016226-1 CASAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 CHURCH ST
Mailing Address - Street 2:SANCIA RECOVERY INC
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601
Mailing Address - Country:US
Mailing Address - Phone:914-421-0400
Mailing Address - Fax:914-421-0401
Practice Address - Street 1:20 CHURCH ST
Practice Address - Street 2:SANCIA RECOVERY INC
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-421-0400
Practice Address - Fax:914-421-0401
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY114273101YA0400X
NY016226104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)