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NPI Code Detail

MEDICARE: KELSEY GRACE CRAYTHORNE MS

MEDICARE: KELSEY GRACE CRAYTHORNE MS
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
1101YM0800XMental Health Counselor28846FL

General Provider Information

NPI Number : 1518826452
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY GRACE CRAYTHORNE MS
Provider Business Mailing Address
First Line : 14401 OLD CUTLER RD
Second Line :
City : PALMETTO BAY
State : FL
Zip : 33158-1722
Country : US
Telephone Number : 305-722-5380
Fax Number :
Provider Business Practice Location Address
First Line : 14401 OLD CUTLER RD
Second Line :
City : PALMETTO BAY
State : FL
Zip : 33158-1722
Country : US
Telephone Number : 305-722-5380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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