Provider Demographics
NPI:1073169553
Name:PACIC, KAYLA (MA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:PACIC
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:SCHRAMSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4341 SUMMERLANE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9507
Mailing Address - Country:US
Mailing Address - Phone:616-558-6837
Mailing Address - Fax:
Practice Address - Street 1:23100 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2756
Practice Address - Country:US
Practice Address - Phone:586-335-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional