Provider Demographics
NPI:1043034317
Name:MYERS, CYNTHIA PAGE (MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:PAGE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 OAK ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-1463
Mailing Address - Country:US
Mailing Address - Phone:937-469-4126
Mailing Address - Fax:
Practice Address - Street 1:647 OAK ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1463
Practice Address - Country:US
Practice Address - Phone:937-469-4126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00000231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical