MEDICARE: GAYLE M CRAVENS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103TC0700X	Clinical Psychologist
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist
5	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1972702223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAYLE M CRAVENS

Provider Business Mailing Address
First Line	:	367B N PARKWAY STE 1
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2899
Country	:	US
Telephone Number	:	731-668-2277
Fax Number	:	731-660-0510

Provider Business Practice Location Address
First Line	:	367B N PARKWAY STE 1
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2899
Country	:	US
Telephone Number	:	731-668-2277
Fax Number	:	731-660-0510

Authorized Official
Title or Position	:	OWNER
Name	:	GAYLE MICHAEL CRAVENS
Credential	:	DR,LPC,LMFT
Telephone Number	:	731-608-3977

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/19/2023

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Directions to “GAYLE M CRAVENS ” Practice Location

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