Provider Demographics
NPI:1619664158
Name:LEWIS, KAYLA S (MS, LPCA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:S
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 COLLINS PATH APT 4
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8477
Mailing Address - Country:US
Mailing Address - Phone:662-207-5176
Mailing Address - Fax:
Practice Address - Street 1:205 CHAMPION WAY STE 11
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8862
Practice Address - Country:US
Practice Address - Phone:502-603-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY285344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health