Provider Demographics
NPI:1508480732
Name:JADIN, KAYLA (MS ED, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:JADIN
Suffix:
Gender:F
Credentials:MS ED, LPC, NCC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:VANDENBUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6502 GRAND TETON PLZ STE 204
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1047
Mailing Address - Country:US
Mailing Address - Phone:608-338-1786
Mailing Address - Fax:608-831-4383
Practice Address - Street 1:6502 GRAND TETON PLZ STE 204
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1047
Practice Address - Country:US
Practice Address - Phone:608-338-1786
Practice Address - Fax:608-831-4383
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4588-226101YM0800X
WI8381-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4588-226OtherTRAINING LICENSE