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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