MEDICARE: KAYLA ASH SHEFFIELD LCSW

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
1	1041C0700X	Clinical Social Worker	60737	TX

General Provider Information

NPI Number	:	1336888783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA ASH SHEFFIELD LCSW

Provider Business Mailing Address
First Line	:	5668 EDWARDS RANCH RD STE 301
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4107
Country	:	US
Telephone Number	:	877-504-8504
Fax Number	:	855-420-6402

Provider Business Practice Location Address
First Line	:	5668 EDWARDS RANCH RD STE 301
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4107
Country	:	US
Telephone Number	:	877-504-8504
Fax Number	:	855-420-6402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	06/09/2022

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