Provider Demographics
NPI:1417400706
Name:LEDDY, KAYLA ANN (LIMHP, LPC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:LEDDY
Suffix:
Gender:F
Credentials:LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 PACIFIC ST STE 100A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-5466
Mailing Address - Country:US
Mailing Address - Phone:308-210-8487
Mailing Address - Fax:
Practice Address - Street 1:7701 PACIFIC ST STE 100A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:308-210-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10955101YM0800X
NE2058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health