Provider Demographics
NPI:1801506282
Name:DYE, CECILIA (LMSW)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:DYE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LAKEFOREST BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2629
Mailing Address - Country:US
Mailing Address - Phone:301-389-5026
Mailing Address - Fax:
Practice Address - Street 1:101 LAKEFOREST BLVD STE 302
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2629
Practice Address - Country:US
Practice Address - Phone:301-389-5026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29250104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD29250OtherLICENSE