Provider Demographics
NPI:1093464240
Name:REEVE, KAYLA ANN (LMFTA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:REEVE
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3928 LAKE BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-9417
Mailing Address - Country:US
Mailing Address - Phone:818-633-8375
Mailing Address - Fax:
Practice Address - Street 1:5200 PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3669
Practice Address - Country:US
Practice Address - Phone:704-272-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12381A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist