Provider Demographics
NPI:1790832004
Name:CECIL, CYNTHIA P (LSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:P
Last Name:CECIL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 ELMHURST CIR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2946
Mailing Address - Country:US
Mailing Address - Phone:412-580-7146
Mailing Address - Fax:
Practice Address - Street 1:1126 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3768
Practice Address - Country:US
Practice Address - Phone:909-982-8641
Practice Address - Fax:909-982-8642
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW27947104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker