Provider Demographics
NPI:1083359657
Name:LENHOFF, KAYLA (CDCA, LSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:LENHOFF
Suffix:
Gender:F
Credentials:CDCA, LSW
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:TSCHUDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDCA, LSW
Mailing Address - Street 1:677 W BROADWAY APT A
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-1267
Mailing Address - Country:US
Mailing Address - Phone:330-447-1514
Mailing Address - Fax:
Practice Address - Street 1:65 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1874
Practice Address - Country:US
Practice Address - Phone:740-654-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2207224101YM0800X
OHCDCA.179480101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health