Provider Demographics
NPI:1750853487
Name:FLOYD, KERRY (LGSW)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-0098
Mailing Address - Country:US
Mailing Address - Phone:334-372-4671
Mailing Address - Fax:
Practice Address - Street 1:107 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2507
Practice Address - Country:US
Practice Address - Phone:334-372-4671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty