Provider Demographics
NPI:1871621110
Name:WILLIAMS, CYNTHIA DARLENE (MSW, LCSW, ACSW, BCD)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DARLENE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW, LCSW, ACSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3845 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-3573
Mailing Address - Country:US
Mailing Address - Phone:314-427-2746
Mailing Address - Fax:
Practice Address - Street 1:3845 BROWN RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-3573
Practice Address - Country:US
Practice Address - Phone:314-427-2746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040045991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical