Healthcare Provider Details

I. General information

NPI: 1346479078
Provider Name (Legal Business Name): CYNTHIA RUIZ MORAN LCSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA RUIZ LCSW

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6721 OLD JONESTOWN RD
HARRISBURG PA
17112-3329
US

IV. Provider business mailing address

2227 OLD EMMORTON RD SUITE 119
BEL AIR MD
21015-6187
US

V. Phone/Fax

Practice location:
  • Phone: 717-215-9881
  • Fax:
Mailing address:
  • Phone: 800-305-2089
  • Fax: 410-569-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW016286
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: