Provider Demographics
NPI:1881804912
Name:STAMPER, CYNTHIA M (MSS, LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:M
Last Name:STAMPER
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:STAMPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSS, LCSW
Mailing Address - Street 1:6901 OLD YORK RD
Mailing Address - Street 2:APT. D302
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-2234
Mailing Address - Country:US
Mailing Address - Phone:215-224-3962
Mailing Address - Fax:
Practice Address - Street 1:6901 OLD YORK RD
Practice Address - Street 2:APT. D302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19126-2234
Practice Address - Country:US
Practice Address - Phone:267-752-3174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0168601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical