Provider Demographics
NPI:1205478310
Name:THOMAS, CYNTHIA MAXWELL (LCSW,LCAS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MAXWELL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW,LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 WHITE OAK XING
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8479
Mailing Address - Country:US
Mailing Address - Phone:252-241-8266
Mailing Address - Fax:
Practice Address - Street 1:714 W CORBETT AVE
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8438
Practice Address - Country:US
Practice Address - Phone:252-241-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25730101YA0400X
NCCO149211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)