Provider Demographics
NPI:1083829295
Name:KADE, KAYA TANIA (LPC, CDMS, CP)
Entity Type:Individual
Prefix:
First Name:KAYA
Middle Name:TANIA
Last Name:KADE
Suffix:
Gender:F
Credentials:LPC, CDMS, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 ACADEMY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-5391
Mailing Address - Country:US
Mailing Address - Phone:907-743-9994
Mailing Address - Fax:907-743-9904
Practice Address - Street 1:1805 ACADEMY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-5391
Practice Address - Country:US
Practice Address - Phone:907-743-9994
Practice Address - Fax:907-743-9904
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA65101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional