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General NPI Number Information
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NPI Number | 1710391248
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Entity Type | Individual
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Provider Name | CYNDI GAYLE ANTONI LSCSW
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Gender | Female
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 601 E WASHINGTON ST
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City | ARMA
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State | KS
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Zip | 66712-4001
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Country | US
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Telephone | 620-347-4033
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1832
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City | PITTSBURG
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State | KS
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Zip | 66762-1832
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Country | US
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Telephone |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 00807
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4735
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License Number State | KS
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