Active NPI
Kylie Craine, PSY.D.
- Psychologist
- Douglasville, GA
National Provider Identifier
1154631042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY003413
- Practice address
- 6264 Hospital Way
Douglasville, GA 30134-1944 - Phone
- (678) 977-8300
- NPI assigned
- Oct 14, 2010
- Last updated
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY003413 | GA | Primary |
Addresses
Primary practice location
6264 Hospital Way
Douglasville, GA 30134-1944
Mailing address
PO Box 1916
Douglasville, GA 30133-1916
Phone (678) 977-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY003413 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1154631042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1916",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301331916",
"telephone_number": "678-977-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6264 HOSPITAL WAY",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301341944",
"telephone_number": "678-977-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAINE",
"first_name": "KYLIE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-14",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "PSY003413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.