Provider Demographics
NPI:1215585179
Name:LAWRENCE, KAYLA (LCSW-S)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 LEMMON AVE STE 726
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1401
Mailing Address - Country:US
Mailing Address - Phone:214-267-8736
Mailing Address - Fax:
Practice Address - Street 1:4848 LEMMON AVE STE 726
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1401
Practice Address - Country:US
Practice Address - Phone:214-267-8736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX564311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical