Provider Demographics
NPI:1679529226
Name:CYS
Entity Type:Organization
Organization Name:CYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENEEN
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:WYSOCKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-303-2641
Mailing Address - Street 1:PO BOX 1605
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21041-1605
Mailing Address - Country:US
Mailing Address - Phone:410-303-2641
Mailing Address - Fax:
Practice Address - Street 1:3810 SPRING MEADOW DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-5140
Practice Address - Country:US
Practice Address - Phone:410-303-2641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD067531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty