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General NPI Number Information
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NPI Number | 1558025742
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Entity Type | Individual
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Provider Name | CYNTHIA ROBERTSON LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 3463 LOGANVIEW DR
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City | DUNDALK
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State | MD
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Zip | 21222-5950
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Country | US
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Telephone | 443-891-6957
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 S TOLLGATE RD STE 200
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City | BEL AIR
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State | MD
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Zip | 21015-5902
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Country | US
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Telephone | 443-591-9945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 26576
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License Number State | MD
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