Provider Demographics
NPI:1962564187
Name:CROSBY, GAYLAIN MONYA (LPA)
Entity type:Individual
Prefix:MS
First Name:GAYLAIN
Middle Name:MONYA
Last Name:CROSBY
Suffix:
Gender:F
Credentials:LPA
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Other - First Name:
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Mailing Address - Street 1:330 MARYS GROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-9345
Mailing Address - Country:US
Mailing Address - Phone:704-730-9211
Mailing Address - Fax:
Practice Address - Street 1:917 1ST ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3958
Practice Address - Country:US
Practice Address - Phone:704-480-6641
Practice Address - Fax:704-480-1364
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1846103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107347Medicaid