Healthcare Provider Details

I. General information

NPI: 1093557993
Provider Name (Legal Business Name): CAYLA DANIELLE STRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 E 1ST ST
ROME GA
30161-3104
US

IV. Provider business mailing address

3 CENTRAL PLZ # 187
ROME GA
30161-3230
US

V. Phone/Fax

Practice location:
  • Phone: 706-509-0130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016733
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: