Kyra Anderson
Individual provider Active NPI Marriage & Family Therapist · Fayetteville, GA
NPI 1639858707 · NPPES record last updated Jul 14, 2023
Key facts
- NPI
- 1639858707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- AMFT000711 (GA)
- Practice address
- 500 Lanier Ave W Ste 908
Fayetteville, GA 30214-7641 - Phone
- (770) 769-5322
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT000711 | GA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT000711 | GA | Yes |
Addresses
Primary practice location
500 Lanier Ave W Ste 908
Fayetteville, GA 30214-7641
Mailing address
159 Aubree Way
McDonough, GA 30252-2417
Other providers in Fayetteville, GA
- Samantha T Amtmann
- Young H An
- Eucharia Nkechi Anachebe
- Dianna Marie Anderson
- Emma Day Anderson
- Louis P. Anderson
- Odell Anderson Jr.
- Reginald Lamont Anderson
- Sharitha Anderson
- Anesthesia Adjunct Services, LLC
All providers in Fayetteville, GA · Marriage & Family Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.