Provider Demographics
NPI:1831286665
Name:CYR, MAUREEN M (LCSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:M
Last Name:CYR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11303 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-6003
Mailing Address - Country:US
Mailing Address - Phone:310-482-6613
Mailing Address - Fax:310-313-0813
Practice Address - Street 1:11303 W WASHINGTON BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6003
Practice Address - Country:US
Practice Address - Phone:310-482-6606
Practice Address - Fax:310-313-0813
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 206941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical