Provider Demographics
NPI:1578257929
Name:SPARROW, KAYLEA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:KAYLEA
Middle Name:
Last Name:SPARROW
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:KAYLEA
Other - Middle Name:NICOLE
Other - Last Name:SPARROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:2359 HENDERSONVILLE RD APT 12
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-3145
Mailing Address - Country:US
Mailing Address - Phone:980-215-5160
Mailing Address - Fax:
Practice Address - Street 1:1293 HENDERSONVILLE RD SUITE 19
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-3145
Practice Address - Country:US
Practice Address - Phone:828-254-0749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health