Provider Demographics
NPI:1316358310
Name:MULLIN, KAYLA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:MULLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3040 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 3308
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3380
Mailing Address - Country:US
Mailing Address - Phone:304-212-5526
Mailing Address - Fax:304-241-5162
Practice Address - Street 1:3040 UNIVERSITY AVE
Practice Address - Street 2:SUITE 3308
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3380
Practice Address - Country:US
Practice Address - Phone:304-212-5526
Practice Address - Fax:304-241-5162
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional