MEDICARE: CYNTHIA DREW LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5466	NV

General Provider Information

NPI Number	:	1104034727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA DREW LCSW

Provider Business Mailing Address
First Line	:	7473 W LAKE MEAD BLVD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0265
Country	:	US
Telephone Number	:	702-562-1211
Fax Number	:	702-562-8157

Provider Business Practice Location Address
First Line	:	7473 W LAKE MEAD BLVD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0265
Country	:	US
Telephone Number	:	702-562-1211
Fax Number	:	702-562-8157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	01/07/2013

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