Provider Demographics
NPI:1508406323
Name:DURNELL, KAYLEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:
Last Name:DURNELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KAYLEE
Other - Middle Name:
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1185 W CARMEL DR STE D4
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8708
Mailing Address - Country:US
Mailing Address - Phone:814-282-5489
Mailing Address - Fax:
Practice Address - Street 1:1185 W CARMEL DR STE D4
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8708
Practice Address - Country:US
Practice Address - Phone:317-569-5433
Practice Address - Fax:317-569-1767
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008009A104100000X
IN34008571A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker