Provider Demographics
NPI:1487951489
Name:WILCOX, CYNTHIA COX (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:COX
Last Name:WILCOX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ROBIE ST
Mailing Address - Street 2:VILLAGE ELEMENTARY SCHOOL
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 ROBIE ST
Practice Address - Street 2:VILLAGE ELEMENTARY SCHOOL
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1710
Practice Address - Country:US
Practice Address - Phone:207-222-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC52371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical