Lake, Cynthia Susan
Lake, Cynthia Susan is an sole proprietor health care provider with primary practice located at 3421 Mike Padgett Hwy , Augusta GA 30906-3815. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Lake, Cynthia Susan can be contacted via phone (706) 432-4872.Contact Information
Primary practice address
3421 Mike Padgett Hwy
Augusta GA 30906-3815
Phone: (706) 432-4872
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | CSW003225 | Georgia |
Profile Details
| NPI number | 1255315842 |
|---|---|
| LBN Legal business name | Lake, Cynthia Susan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2005 |
| Last updated | Mar 27th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255315842 | NPPES |
| Georgia | MEDICAID | 000606317B |
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