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NPI Code Detail

MEDICARE: CYS

MEDICARE: CYS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker06753MD

General Provider Information

NPI Number : 1679529226
Entity Type Code : Organization
Provider Name (Legal Business Name) : CYS
Provider Business Mailing Address
First Line : PO BOX 1605
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21041-1605
Country : US
Telephone Number : 410-303-2641
Fax Number :
Provider Business Practice Location Address
First Line : 3810 SPRING MEADOW DR
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-5140
Country : US
Telephone Number : 410-303-2641
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MRS. DENEEN THERESA WYSOCKI
Credential : LCSW-C
Telephone Number : 410-303-2641
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/22/2020

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Directions to “CYS ” Practice Location

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