Provider Demographics
NPI:1902109838
Name:CYNTHIA W. TASKA, LLC
Entity Type:Organization
Organization Name:CYNTHIA W. TASKA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TASKA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:802-744-6163
Mailing Address - Street 1:1926 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:VT
Mailing Address - Zip Code:05847-9647
Mailing Address - Country:US
Mailing Address - Phone:802-744-6163
Mailing Address - Fax:
Practice Address - Street 1:1926 VALLEY RD
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:VT
Practice Address - Zip Code:05847-9647
Practice Address - Country:US
Practice Address - Phone:802-744-6163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.00628311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty