Organization
CYNTHIA SONTAG, LCSW
Active
Organization
CYNTHIA SONTAG, LCSW
Active
Other names
The Source Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA SONTAG LCSW (SOCIAL WORKER)
(505) 263-1001
Entity
Organization
Contact information
Practice address
310 13TH ST NW, ALBUQUERQUE, NM 87102-1834
(505) 263-1001
(505) 234-1019
Mailing address
310 13TH ST NW, ALBUQUERQUE, NM 87102-1834
(505) 263-1001
(505) 234-1019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-1991
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
528708
MEDICARE PTAN
NM
Enumeration date
11/25/2016
Last updated
11/25/2016
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