Provider Demographics
NPI:1972204865
Name:CYRUS-HOLLINGSWORTH, BRITTANY (PSYD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:CYRUS-HOLLINGSWORTH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:POCA
Mailing Address - State:WV
Mailing Address - Zip Code:25159-0128
Mailing Address - Country:US
Mailing Address - Phone:304-769-8077
Mailing Address - Fax:
Practice Address - Street 1:300 KENTON DR STE 3
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1266
Practice Address - Country:US
Practice Address - Phone:304-941-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
WV1330103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant