Provider Demographics
NPI:1083264477
Name:PARIS, KAYLA ROSE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ROSE
Last Name:PARIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2236
Mailing Address - Country:US
Mailing Address - Phone:207-391-4344
Mailing Address - Fax:207-249-6060
Practice Address - Street 1:49 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2236
Practice Address - Country:US
Practice Address - Phone:207-391-4344
Practice Address - Fax:207-249-6060
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL5469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional