Provider Demographics
NPI:1457124505
Name:BYRD, CECIL CURTIS II
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:CURTIS
Last Name:BYRD
Suffix:II
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 1:6755 BUSINESS PKWY STE 409
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6749
Mailing Address - Country:US
Mailing Address - Phone:410-905-4763
Mailing Address - Fax:
Practice Address - Street 1:6755 BUSINESS PKWY STE 409
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6749
Practice Address - Country:US
Practice Address - Phone:202-680-3142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0039103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical