MEDICARE: MR. CYRUS LOMONT WHEELER MS, LLPC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871891887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CYRUS LOMONT WHEELER MS, LLPC

Provider Business Mailing Address
First Line	:	14629 SNOWDEN ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-3685
Country	:	US
Telephone Number	:	313-340-9752
Fax Number	:

Provider Business Practice Location Address
First Line	:	14629 SNOWDEN ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-3685
Country	:	US
Telephone Number	:	313-340-9752
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2011
Last Update Date	:	05/20/2026

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