Healthcare Provider Details

I. General information

NPI: 1497481162
Provider Name (Legal Business Name): KAILEY CROMER SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 ELLEN ST STE B
MONROE NC
28112-5286
US

IV. Provider business mailing address

13663 PROVIDENCE RD # 355
WEDDINGTON NC
28104-9373
US

V. Phone/Fax

Practice location:
  • Phone: 704-438-9901
  • Fax:
Mailing address:
  • Phone: 704-438-9901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: