Provider Demographics
NPI:1619477643
Name:CREW, KAYLA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:CREW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2233 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4701
Mailing Address - Country:US
Mailing Address - Phone:419-281-3716
Mailing Address - Fax:330-264-0946
Practice Address - Street 1:2233 ROCKY LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4701
Practice Address - Country:US
Practice Address - Phone:419-281-3716
Practice Address - Fax:330-264-0946
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.19011826-TRNE101Y00000X
171M00000X
OHC.2002671101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator