Healthcare Provider Details

I. General information

NPI: 1023937190
Provider Name (Legal Business Name): CAYLA WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6419 BANNINGTON RD STE B
CHARLOTTE NC
28226-1341
US

IV. Provider business mailing address

6419 BANNINGTON RD STE B
CHARLOTTE NC
28226-1341
US

V. Phone/Fax

Practice location:
  • Phone: 704-533-5810
  • Fax: 980-598-8019
Mailing address:
  • Phone: 704-533-5810
  • Fax: 980-598-8019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23203
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: