Provider Demographics
NPI:1952392920
Name:BROWN, CYNTHIA J (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-1528
Mailing Address - Country:US
Mailing Address - Phone:978-835-8497
Mailing Address - Fax:
Practice Address - Street 1:71 SUMMER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5853
Practice Address - Country:US
Practice Address - Phone:978-835-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10248301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1855344Medicaid
MD2274371OtherFIRST HEALTH
MA62-83272OtherUNITED BEHAVIORAL HEALTH
MAP08356OtherBLUE CROSS BLUE SHIELD
MA11352634OtherCAQH
MA485625OtherVALUE OPTIONS
MA232004OtherCOMPSYCH CORPORATION
MA1855344Medicaid