Provider Demographics
NPI:1699210526
Name:CROWN, CYNTHIA J (LCSW-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:CROWN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DULANEY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2702
Mailing Address - Country:US
Mailing Address - Phone:410-567-1117
Mailing Address - Fax:443-470-9137
Practice Address - Street 1:1010 DULANEY VALLEY RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-567-1117
Practice Address - Fax:443-470-9137
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD116411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical