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NPI Code Detail

MEDICARE: CYNTHIA CARRELL LCSW

MEDICARE:   CYNTHIA  CARRELL  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
11041C0700XClinical Social Worker15570AZ

General Provider Information

NPI Number : 1417405523
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA CARRELL LCSW
Provider Business Mailing Address
First Line : 301 E BETHANY HOME RD STE C189
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1295
Country : US
Telephone Number : 480-313-0020
Fax Number :
Provider Business Practice Location Address
First Line : 301 E BETHANY HOME RD STE C189
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1295
Country : US
Telephone Number : 480-313-0020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2016
Last Update Date : 11/30/2025

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Directions to “ CYNTHIA CARRELL LCSW” Practice Location

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