Provider Demographics
NPI:1053580324
Name:WINDER, CYNTHIA R (LMSWCEAPCCDP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:R
Last Name:WINDER
Suffix:
Gender:F
Credentials:LMSWCEAPCCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7994
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-0994
Mailing Address - Country:US
Mailing Address - Phone:302-477-0821
Mailing Address - Fax:
Practice Address - Street 1:4610 PENNELL RD
Practice Address - Street 2:
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-1863
Practice Address - Country:US
Practice Address - Phone:302-743-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2010-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124540104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
11835292OtherCAQH