Provider Demographics
NPI:1083067334
Name:MORGAN, KAYLA M (LISW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 STUTZ DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9155
Mailing Address - Country:US
Mailing Address - Phone:330-729-9514
Mailing Address - Fax:330-729-9591
Practice Address - Street 1:3685 STUTZ DR STE 101
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9155
Practice Address - Country:US
Practice Address - Phone:330-729-9514
Practice Address - Fax:330-729-9591
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20020601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0283973Medicaid