Provider Demographics
NPI:1912364712
Name:DE SALA BAEZ, CYNDIBELL (LMSW)
Entity Type:Individual
Prefix:
First Name:CYNDIBELL
Middle Name:
Last Name:DE SALA BAEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 AMSTERDAM AVE
Mailing Address - Street 2:APT. 4J,
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2440 AMSTERDAM AVE
Practice Address - Street 2:APT. 4J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3323
Practice Address - Country:US
Practice Address - Phone:347-236-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker