Healthcare Provider Details

I. General information

NPI: 1598152837
Provider Name (Legal Business Name): CYNTHIA ANAHI HIGH-GUTIERREZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 BRODHEAD RD
BETHLEHEM PA
18017-8938
US

IV. Provider business mailing address

257 BRODHEAD RD
BETHLEHEM PA
18017-8938
US

V. Phone/Fax

Practice location:
  • Phone: 484-822-5700
  • Fax: 866-521-0526
Mailing address:
  • Phone: 484-822-5700
  • Fax: 866-521-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801112107
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW022924
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: