MEDICARE: KRISTEL BYRD 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	C016370	NC
2	1041C0700X	Clinical Social Worker	0904015578	VA

General Provider Information

NPI Number	:	1811677636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEL BYRD LCSW

Provider Business Mailing Address
First Line	:	921 TOWN CENTRE BLVD # 508
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-2181
Country	:	US
Telephone Number	:	994-223-0516
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 TOWN CENTRE BLVD # 508
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-2181
Country	:	US
Telephone Number	:	984-223-0516
Fax Number	:

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

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	05/14/2026

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Directions to “ KRISTEL BYRD LCSW” Practice Location

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