Healthcare Provider Details

I. General information

NPI: 1629905773
Provider Name (Legal Business Name): KEVIN ROGER CYR CMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WHITING ST STE 3
HINGHAM MA
02043-3724
US

IV. Provider business mailing address

210 WHITING ST STE 3
HINGHAM MA
02043-3724
US

V. Phone/Fax

Practice location:
  • Phone: 781-776-1222
  • Fax:
Mailing address:
  • Phone: 781-776-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLICSW113459
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: