Individual provider Active NPI

Cynthia Christopherson, L.C.S.W; B.C.A.B.A

  • Clinical Social Worker
  • Port St Lucie, FL
National Provider Identifier
1073771200
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW-8718 Issued in FL
Practice address
224 NW Magnolia Lakes Blvd
Port St Lucie, FL 34986-3580
Phone
(772) 708-9711
Fax
(772) 785-8716
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW-8718 FL Primary

Addresses

Primary practice location

224 NW Magnolia Lakes Blvd
Port St Lucie, FL 34986-3580

Mailing address

224 NW Magnolia Lakes Blvd
Port St Lucie, FL 34986-3580
Phone (772) 708-9711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW-8718FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1073771200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 NW MAGNOLIA LAKES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863580",
            "telephone_number": "772-708-9711",
            "fax_number": "772-785-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 NW MAGNOLIA LAKES BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863580",
            "telephone_number": "772-708-9711",
            "fax_number": "772-785-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSON",
        "first_name": "CYNTHIA",
        "credential": "L.C.S.W;  B.C.A.B.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW-8718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.