Provider Demographics
NPI:1164735239
Name:KAYLOR, LEE ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEE
Middle Name:ANNE
Last Name:KAYLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:ANNE
Other - Last Name:BRUENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:60 WEST SUNBRIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-695-1240
Practice Address - Fax:479-750-8967
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1512C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical