Provider Demographics
NPI:1851497689
Name:HERNANDEZ, CYNTHIA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6519 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-5108
Mailing Address - Country:US
Mailing Address - Phone:713-459-3361
Mailing Address - Fax:713-861-5330
Practice Address - Street 1:627 W 19TH ST
Practice Address - Street 2:2033
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3685
Practice Address - Country:US
Practice Address - Phone:713-459-3361
Practice Address - Fax:713-861-5330
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081PMedicare ID - Type Unspecified
TX83611WMedicare ID - Type Unspecified