Provider Demographics
NPI:1740613900
Name:KRAY, KATHLEEN ZERA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ZERA
Last Name:KRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W HILL ST
Mailing Address - Street 2:SUITE 204-D
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4367
Mailing Address - Country:US
Mailing Address - Phone:404-895-9485
Mailing Address - Fax:
Practice Address - Street 1:317 W HILL ST
Practice Address - Street 2:SUITE 204-D
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4367
Practice Address - Country:US
Practice Address - Phone:404-895-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0039851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical