Provider Demographics
NPI:1629103296
Name:CYR, DOUGLAS P (MFT, RDT)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:P
Last Name:CYR
Suffix:
Gender:M
Credentials:MFT, RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 QUAIL CT
Mailing Address - Street 2:STE 201
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5592
Mailing Address - Country:US
Mailing Address - Phone:415-595-0740
Mailing Address - Fax:855-464-0770
Practice Address - Street 1:37 QUAIL CT
Practice Address - Street 2:SUITE 201
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5592
Practice Address - Country:US
Practice Address - Phone:415-595-0740
Practice Address - Fax:855-464-0770
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist