Provider Demographics
NPI:1376847434
Name:LAWSON, CYNTHIA COLLEEN (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:COLLEEN
Last Name:LAWSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:COLLEEN
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-0345
Mailing Address - Country:US
Mailing Address - Phone:605-650-2064
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 345
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-0345
Practice Address - Country:US
Practice Address - Phone:830-360-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 1041C0700X, 174H00000X, 174H00000X, 390200000X
TX1063871041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174H00000XOther Service ProvidersHealth Educator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program