Provider Demographics
NPI:1952049918
Name:TWEEDY, CYNTHIA JEAN (MSW, LLMSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:JEAN
Last Name:TWEEDY
Suffix:
Gender:F
Credentials:MSW, LLMSW
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:JEAN
Other - Last Name:JANUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3010 WOODLAND HILLS DR APT 32
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2107
Mailing Address - Country:US
Mailing Address - Phone:517-414-0943
Mailing Address - Fax:
Practice Address - Street 1:3010 WOODLAND HILLS DR APT 32
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2107
Practice Address - Country:US
Practice Address - Phone:517-414-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851114398104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker