Provider Demographics
NPI:1811016835
Name:LOWENTHAL, CYNTHIA L (MSW, LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:LOWENTHAL
Suffix:
Gender:F
Credentials:MSW, LCSW, BCD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:S
Other - Last Name:LOWENTHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW, BCD
Mailing Address - Street 1:11363 SUNSET HILLS RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5205
Mailing Address - Country:US
Mailing Address - Phone:703-925-0299
Mailing Address - Fax:703-437-1908
Practice Address - Street 1:11363 SUNSET HILLS ROAD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5205
Practice Address - Country:US
Practice Address - Phone:703-925-0299
Practice Address - Fax:703-437-1908
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040008151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY130314OtherVALUEOPTIONS
VA040621OtherANTHEM BLUE CROSS BLUE SH
CA130314OtherVALUEOPTIONS