Healthcare Provider Details

I. General information

NPI: 1134310584
Provider Name (Legal Business Name): CYNTHIA ANNE BOOKER-BINGLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA ANNE BOOKER LCSW

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 SURRY RD
SURRY ME
04684-3410
US

IV. Provider business mailing address

1161 SURRY RD
SURRY ME
04684-3410
US

V. Phone/Fax

Practice location:
  • Phone: 207-610-2701
  • Fax: 207-412-0972
Mailing address:
  • Phone: 207-610-2701
  • Fax: 207-412-0972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC13211
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: