Provider Demographics
NPI:1164920724
Name:SNAVLEY, KAYLA H (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:H
Last Name:SNAVLEY
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 FOXTAIL CHASE
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-2923
Mailing Address - Country:US
Mailing Address - Phone:719-439-9255
Mailing Address - Fax:
Practice Address - Street 1:116 PIERCE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2891
Practice Address - Country:US
Practice Address - Phone:478-464-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2023-11-06
Deactivation Date:2018-10-05
Deactivation Code:
Reactivation Date:2020-10-14
Provider Licenses
StateLicense IDTaxonomies
GAAPC007520101YP2500X
GALPC014252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional