Provider Demographics
NPI:1538692355
Name:MICHELE CYR, LCSW
Entity Type:Organization
Organization Name:MICHELE CYR, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:951-970-0372
Mailing Address - Street 1:4199 FLAT ROCK DR
Mailing Address - Street 2:#105
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-7115
Mailing Address - Country:US
Mailing Address - Phone:951-970-0372
Mailing Address - Fax:951-710-9567
Practice Address - Street 1:4199 FLAT ROCK DR
Practice Address - Street 2:#105
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-7115
Practice Address - Country:US
Practice Address - Phone:951-970-0372
Practice Address - Fax:951-710-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS167241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty