Healthcare Provider Details

I. General information

NPI: 1710775572
Provider Name (Legal Business Name): CYPRESS CREEK THERAPY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MAYO RD STE 105
EDGEWATER MD
21037-1439
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 410-956-7868
  • Fax: 410-384-9703
Mailing address:
  • Phone:
  • Fax: 812-590-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA MCCAULEY
Title or Position: CHIEF LEGAL AND COMPLIANCE OFFICER
Credential:
Phone: 502-576-3300