Provider Demographics
NPI:1083329890
Name:CLOUD, KAYLA (LPC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:CLOUD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 PHEASANT HILL LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-2954
Mailing Address - Country:US
Mailing Address - Phone:832-740-3605
Mailing Address - Fax:
Practice Address - Street 1:643 PHEASANT HILL LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2954
Practice Address - Country:US
Practice Address - Phone:832-740-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional