Provider Demographics
NPI:1780166710
Name:SMITH, CYNTHIA (ASW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5520
Mailing Address - Country:US
Mailing Address - Phone:805-478-7271
Mailing Address - Fax:
Practice Address - Street 1:117 W TUNNELL ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4096
Practice Address - Country:US
Practice Address - Phone:805-614-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA842201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical