Provider Demographics
NPI:1841927266
Name:BYRD, EDDIE (CLINICAL SUPERVISOR)
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:
Last Name:BYRD
Suffix:
Gender:M
Credentials:CLINICAL SUPERVISOR
Other - Prefix:MR
Other - First Name:EDDIE
Other - Middle Name:
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CACII, CCS
Mailing Address - Street 1:600 COMMERCIAL CT STE A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3671
Mailing Address - Country:US
Mailing Address - Phone:912-352-4357
Mailing Address - Fax:
Practice Address - Street 1:600 COMMERCIAL CT STE A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3671
Practice Address - Country:US
Practice Address - Phone:912-352-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)