Provider Demographics
NPI:1871891887
Name:WHEELER, CYRUS LOMONT (MS, LLPC)
Entity type:Individual
Prefix:MR
First Name:CYRUS
Middle Name:LOMONT
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MS, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14629 SNOWDEN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-3685
Mailing Address - Country:US
Mailing Address - Phone:313-340-9752
Mailing Address - Fax:
Practice Address - Street 1:14629 SNOWDEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-3685
Practice Address - Country:US
Practice Address - Phone:313-340-9752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health