Provider Demographics
NPI:1568025575
Name:KAYLA AGAR, PSY.D. LLC
Entity Type:Organization
Organization Name:KAYLA AGAR, PSY.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:MEG
Authorized Official - Last Name:AGAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-987-9188
Mailing Address - Street 1:46 NEPONSET ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-1562
Mailing Address - Country:US
Mailing Address - Phone:617-987-9188
Mailing Address - Fax:617-935-0601
Practice Address - Street 1:46 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-1562
Practice Address - Country:US
Practice Address - Phone:617-987-9188
Practice Address - Fax:617-935-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851816268Medicaid