Holly Cyr, CISW
Individual provider Active NPI Clinical Social Worker · New London, CT
NPI 1154492304 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1154492304
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4124 (CT)
- Practice address
- 365 Montauk Ave
New London, CT 06320-4700 - Phone
- (860) 442-0711
- Fax
- (860) 444-4767
- NPI assigned
- Nov 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Windham Community Memorial Hospital Inc
Practice addresses (Care Compare)
112 Mansfield Ave
Willimantic, CT 06226-2045
Phone (860) 456-9116
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090902000019 | CT | Practitioner - Clinical Social Worker | 3476608175 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4124 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William W Backus Hospital | Current |
Accepting new patients | |
| Windham Community Memorial Hospital, Inc. | Current |
Accepting new patients | |
| The William W Backus Hospital | Current | Accepting new patients | |
| Associated Specialists of Southeastern Connecticut, Inc. | Clinical | Past | Accepting new patients |
Locations
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410
Interoperability endpoints
- hollybeth.cyr@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4124 | CT | Yes |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4700
Mailing address
365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4014679 | Medicaid | CT | |
| 4024972 | Medicaid | CT |
Other providers in New London, CT
- CT Comprehensive Therapy & Community Support Services LLC
- Chelsea Culbert
- Cultivate & Grow Inc.
- Cynthia Curioso-Uy
- Terrlyn L Curry Avery
- Sara Cyr
- Karen M D'Agostino
- Teresa L D'Errico
- Frederick Daddario
- Jeffrey Daley
All providers in New London, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.