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NPI Code Detail

MEDICARE: CYNTHIA VELAZQUEZ LMSW

MEDICARE:   CYNTHIA  VELAZQUEZ  LMSW
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
11041C0700XClinical Social Worker6801122091MI

General Provider Information

NPI Number : 1376329326
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA VELAZQUEZ LMSW
Provider Business Mailing Address
First Line : 3111 ELECTRIC AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-8127
Country : US
Telephone Number : 810-985-8900
Fax Number :
Provider Business Practice Location Address
First Line : 3111 ELECTRIC AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-8127
Country : US
Telephone Number : 810-985-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2023
Last Update Date : 05/04/2026

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Directions to “ CYNTHIA VELAZQUEZ LMSW” Practice Location

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