Provider Demographics
NPI:1174043194
Name:SCHUBERT-WIRTH, KAYLA ANN (MSW, LCSCW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:SCHUBERT-WIRTH
Suffix:
Gender:F
Credentials:MSW, LCSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-4441
Mailing Address - Country:US
Mailing Address - Phone:610-216-9598
Mailing Address - Fax:
Practice Address - Street 1:15 WARREN ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-4441
Practice Address - Country:US
Practice Address - Phone:610-216-9598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0215181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical