Provider Demographics
NPI:1164959672
Name:AYERS, KALA HODGE (LPC)
Entity Type:Individual
Prefix:
First Name:KALA
Middle Name:HODGE
Last Name:AYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KALA
Other - Middle Name:CHRISTINE
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:770 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1187
Mailing Address - Country:US
Mailing Address - Phone:276-223-3206
Mailing Address - Fax:276-223-0617
Practice Address - Street 1:6999 CARROLLTON PIKE
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-6341
Practice Address - Country:US
Practice Address - Phone:276-238-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional