Provider Demographics
NPI:1942427240
Name:VARTERASIAN, CYNTHIA ALLISON (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ALLISON
Last Name:VARTERASIAN
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 1:101 E SPICERVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-1919
Mailing Address - Country:US
Mailing Address - Phone:517-663-9518
Mailing Address - Fax:
Practice Address - Street 1:101 E SPICERVILLE HWY
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-1919
Practice Address - Country:US
Practice Address - Phone:517-663-9518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801057310106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist