Provider Demographics
NPI:1578158341
Name:CORPIN, KAYLA LENORA (LMHC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LENORA
Last Name:CORPIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5229 SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13408-1137
Mailing Address - Country:US
Mailing Address - Phone:315-825-5320
Mailing Address - Fax:
Practice Address - Street 1:199 W DOMINICK ST STE 4
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5878
Practice Address - Country:US
Practice Address - Phone:315-272-2748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011097101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health