Provider Demographics
NPI:1598335820
Name:KAYLA MEADOR COUNSELING LLC
Entity Type:Organization
Organization Name:KAYLA MEADOR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GROGG MEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:304-914-1942
Mailing Address - Street 1:425 INDUSTRIAL AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2287
Mailing Address - Country:US
Mailing Address - Phone:304-914-1942
Mailing Address - Fax:
Practice Address - Street 1:425 INDUSTRIAL AVE STE 201
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2287
Practice Address - Country:US
Practice Address - Phone:304-914-1942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)