Provider Demographics
NPI:1578867107
Name:CYNTHIA A NOFFSINGER LLC
Entity type:Organization
Organization Name:CYNTHIA A NOFFSINGER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOFFSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:262-781-1976
Mailing Address - Street 1:13500 W CAPITOL DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2444
Mailing Address - Country:US
Mailing Address - Phone:262-781-1976
Mailing Address - Fax:262-781-1997
Practice Address - Street 1:13500 W CAPITOL DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2444
Practice Address - Country:US
Practice Address - Phone:262-781-1976
Practice Address - Fax:262-781-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1861-123302F00000X, 302R00000X, 305R00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41003800Medicaid
WI004044255Medicare PIN