Provider Demographics
NPI:1700773207
Name:KENDALL, KAYLA CHRISTINE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:CHRISTINE
Last Name:KENDALL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 DIXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-1707
Mailing Address - Country:US
Mailing Address - Phone:203-645-8682
Mailing Address - Fax:
Practice Address - Street 1:458 GRAND AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-3856
Practice Address - Country:US
Practice Address - Phone:203-752-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22272795101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor