MEDICARE: ANDREE MICHELLE BYRD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	PO18791	NC

General Provider Information

NPI Number	:	1356177406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREE MICHELLE BYRD

Provider Business Mailing Address
First Line	:	2450 ABERDEEN BLVD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0644
Country	:	US
Telephone Number	:	704-277-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	8135 WOODSCAPE DR APT E
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-0252
Country	:	US
Telephone Number	:	980-277-2653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	06/02/2026

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Directions to “ ANDREE MICHELLE BYRD ” Practice Location

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