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General NPI Number Information
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NPI Number | 1669869483
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Entity Type | Individual
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Provider Name | AMELIA MCCROY
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Gender | Female
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 1220 2ND AVE
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City | COLUMBUS
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State | GA
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Zip | 31901-5241
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Country | US
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Telephone | 706-571-9128
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Fax | 706-571-9242
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Provider Business Mailing Address
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Address Line | 2683 TERRATIM LN
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City | DECATUR
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State | GA
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Zip | 30034-1057
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Country | US
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Telephone | 662-902-6508
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW007646
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License Number State | GA
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