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General NPI Number Information
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NPI Number | 1659912582
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Entity Type | Individual
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Provider Name | CYNTHIA WARDEN LCSW, LCDC
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Gender | Female
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 5701 BROADWAY # 207
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City | SAN ANTONIO
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State | TX
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Zip | 78209-5749
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Country | US
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Telephone | 210-580-6022
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Fax | 726-238-3117
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Provider Business Mailing Address
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Address Line | 16515 FOX KNL
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City | SAN ANTONIO
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State | TX
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Zip | 78247-1146
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Country | US
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Telephone | 210-850-4088
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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 | 68011
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 14022
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License Number State | TX
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