Provider Demographics
NPI:1669583795
Name:LOVER, CYNTHIA M (LICSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:LOVER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3914
Mailing Address - Country:US
Mailing Address - Phone:401-784-3530
Mailing Address - Fax:401-784-3549
Practice Address - Street 1:176 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4482
Practice Address - Country:US
Practice Address - Phone:401-737-9240
Practice Address - Fax:401-739-6413
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI013301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICL26928Medicaid