Provider Demographics
NPI:1265095624
Name:HYNSON, CEDRIC TYREE
Entity type:Individual
Prefix:MR
First Name:CEDRIC
Middle Name:TYREE
Last Name:HYNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5127
Mailing Address - Country:US
Mailing Address - Phone:410-844-4110
Mailing Address - Fax:
Practice Address - Street 1:2310 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5127
Practice Address - Country:US
Practice Address - Phone:410-844-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-20
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)