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General NPI Number Information
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NPI Number | 1326406240
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Entity Type | Individual
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Provider Name | PHADRA MCCRAY LSW
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Gender | Female
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 2670 N COLUMBUS ST STE K
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City | LANCASTER
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State | OH
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Zip | 43130-8408
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Country | US
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Telephone | 740-304-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 88 ROCKY CREEK DR
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City | GAHANNA
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State | OH
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Zip | 43230-2682
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Country | US
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Telephone | 614-218-2531
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S1440173
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License Number State | OH
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