Provider Demographics
NPI:1821160789
Name:KATES, CYNTHIA V (MSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:V
Last Name:KATES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BURD LN
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2612
Mailing Address - Country:US
Mailing Address - Phone:609-466-4468
Mailing Address - Fax:609-466-4468
Practice Address - Street 1:52 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1224
Practice Address - Country:US
Practice Address - Phone:609-466-4468
Practice Address - Fax:609-466-4468
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC052241001041C0700X
PACW0138071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP941211OtherOXFORD
NJ2031362000OtherAMERIHEALTH
PA2031362000OtherINDEPENDENCE BCBC
NJ4529160OtherAETNA
PA4529160OtherAETNA
NJP941211OtherOXFORD
NJP941211OtherOXFORD
PA4529160OtherAETNA