| Doctor Name: | CYNTHIA KELLY CASANOVA |
| NPI Number: | 1043427578 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LMHC, NCC |
| License Number: | 000713-1 |
| Business Practice Address: | 7559 263rd St Lowenstein Building, Room 140 Glen Oaks, NY - 110041150 |
| Business Phone Number: | 7184708028 |
| Business Fax Number: | 7189622742 |
| Mailing Address: | 19318 39th Ave, 1st Floor FLUSHING |
| State: | NY |
| Postal Code: | 113584020 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 000713-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |