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Organization

CYS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DENEEN THERESA WYSOCKI LCSW-C (DIRECTOR)
(410) 303-2641
Entity
Organization

Contact information

Practice address
3810 SPRING MEADOW DR, ELLICOTT CITY, MD 21042-5140
(410) 303-2641
Mailing address
PO BOX 1605, ELLICOTT CITY, MD 21041-1605
(410) 303-2641

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
06753
MD

Other

Enumeration date
05/25/2006
Last updated
08/22/2020
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