Provider Demographics
NPI:1710391248
Name:ANTONI, CYNDI GAYLE (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNDI
Middle Name:GAYLE
Last Name:ANTONI
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-1832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ARMA
Practice Address - State:KS
Practice Address - Zip Code:66712-4001
Practice Address - Country:US
Practice Address - Phone:620-347-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00807101YA0400X
KS47351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110931180OtherMEDICARE
KS201095340CMedicaid
MO490073766Medicaid