Provider Demographics
NPI:1891223533
Name:FLAMM, CYNTHIA K (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:FLAMM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:K
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:513 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:IL
Mailing Address - Zip Code:62906-1668
Mailing Address - Country:US
Mailing Address - Phone:618-833-4471
Mailing Address - Fax:618-833-8878
Practice Address - Street 1:513 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:IL
Practice Address - Zip Code:62906-1668
Practice Address - Country:US
Practice Address - Phone:618-833-4471
Practice Address - Fax:618-833-8878
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490069711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical