Provider Demographics
NPI:1033768676
Name:BENDER, KAYLA (LMSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 EAST ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-1946
Mailing Address - Country:US
Mailing Address - Phone:810-238-3333
Mailing Address - Fax:
Practice Address - Street 1:515 EAST ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-1946
Practice Address - Country:US
Practice Address - Phone:810-238-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011049201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical