Provider Demographics
NPI:1770846818
Name:MEYER, CYNTHIA GILLIAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:GILLIAN
Last Name:MEYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CYNDY
Other - Middle Name:GILLIAN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 788
Mailing Address - Street 2:
Mailing Address - City:MT VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96771
Mailing Address - Country:US
Mailing Address - Phone:808-345-5130
Mailing Address - Fax:
Practice Address - Street 1:601 SW CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2139
Practice Address - Country:US
Practice Address - Phone:808-345-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health