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General NPI Number Information
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NPI Number | 1740099787
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Entity Type | Individual
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Provider Name | CYNTHIA ANN CARMACK LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 502 W KEARNEY ST STE 300
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City | MESQUITE
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State | TX
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Zip | 75149-3412
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Country | US
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Telephone | 972-288-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 2946 COOLWOOD LN
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City | ROCKWALL
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State | TX
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Zip | 75032-7289
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Country | US
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Telephone | 940-297-7669
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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 | 105787
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License Number State | TX
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