Provider Demographics
NPI:1609644863
Name:SKARDA, CYNTHIA RAE (MSW, APSW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RAE
Last Name:SKARDA
Suffix:
Gender:F
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8633 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-6460
Mailing Address - Country:US
Mailing Address - Phone:262-331-3181
Mailing Address - Fax:
Practice Address - Street 1:6121 GREENBAY ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142
Practice Address - Country:US
Practice Address - Phone:262-694-3718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127711104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker