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Individual

MRS. CYNTHIA DEWATERS BALOG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC LCADC

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA362
MD
101YP2500X
Professional Counselor
Primary
LC1289
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
461922374
CIGNA
MD
01
62464101
CAREFIRST MD
01
676829
BEACON HEALTH OPTIONS
MD
05
699558600
MD
01
RS830034
CAREFIRST GHMSI
Enumeration date
09/28/2006
Last updated
10/13/2021
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