MEDICARE: CYNTHIA MARTIN GRANT MSW, LSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	162269	OH
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1457851461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MARTIN GRANT MSW, LSW

Provider Business Mailing Address
First Line	:	9520 ALEXANDER RD
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2136
Country	:	US
Telephone Number	:	216-983-9993
Fax Number	:

Provider Business Practice Location Address
First Line	:	9520 ALEXANDER RD
Second Line	:
City	:	GARFIELD HTS
State	:	OH
Zip	:	44125-2136
Country	:	US
Telephone Number	:	216-983-9993
Fax Number	:

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

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	01/07/2025

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