Provider Demographics
NPI:1811328016
Name:LIGOURI, CYNTHIA (L-MSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LIGOURI
Suffix:
Gender:F
Credentials:L-MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:1062 ST. RT. 38
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-0177
Mailing Address - Country:US
Mailing Address - Phone:607-689-8160
Mailing Address - Fax:
Practice Address - Street 1:1062 ST. RT. 38
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-0177
Practice Address - Country:US
Practice Address - Phone:607-689-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069650-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker