Provider Demographics
NPI:1760461958
Name:KAYLOR, LISAJOAN (MSED NCC LPC)
Entity Type:Individual
Prefix:MRS
First Name:LISAJOAN
Middle Name:
Last Name:KAYLOR
Suffix:
Gender:F
Credentials:MSED NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 WATERDAM RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2573
Mailing Address - Country:US
Mailing Address - Phone:724-942-5477
Mailing Address - Fax:724-942-5479
Practice Address - Street 1:157 WATERDAM RD
Practice Address - Street 2:SUITE 260
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2573
Practice Address - Country:US
Practice Address - Phone:724-942-5477
Practice Address - Fax:724-942-5479
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health