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NPI Code Detail

MEDICARE: KAYLA CRAWFORD MSW

MEDICARE: KAYLA CRAWFORD MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1114650587
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA CRAWFORD MSW
Provider Business Mailing Address
First Line : 900 JOSEPH E LOWERY BLVD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30318-5250
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2805 METROPOLITAN PKWY SW
Second Line :
City : ATLANTA
State : GA
Zip : 30315-7915
Country : US
Telephone Number : 678-939-5564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2022
Last Update Date : 07/05/2022

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