Organization Name: | CYNTHIA LEIGH CARLSON LLC |
NPI Number: | 1023302767 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA LEIGH CARLSON (CLINICAL SOCIAL WORKER) |
Mailing Address: | 3970 N Oakland Ave Ste 704 Shorewood |
State: | WI US |
Postal Code: | 532112265 |
Phone Number: | 4149639187 |
Fax Number: | |
NPI Enumeration Date: | 05/28/2011 |
NPI Last Update Date: | 09/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |