Provider Demographics
NPI:1689026957
Name:ARIAS-CARDOSO, CYNTHIA BERENICE (MS, QMHP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:BERENICE
Last Name:ARIAS-CARDOSO
Suffix:
Gender:F
Credentials:MS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 GROVE AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-1764
Mailing Address - Country:US
Mailing Address - Phone:773-837-2238
Mailing Address - Fax:
Practice Address - Street 1:3600 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2319
Practice Address - Country:US
Practice Address - Phone:773-782-5003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health