Provider Demographics
NPI:1790458750
Name:LENE, CAILA (APC)
Entity Type:Individual
Prefix:MS
First Name:CAILA
Middle Name:
Last Name:LENE
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 WHEELER RD STE 609
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6533
Mailing Address - Country:US
Mailing Address - Phone:706-434-3989
Mailing Address - Fax:
Practice Address - Street 1:4839 W. MAYSFIELD DR. SUITE 100-B
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-9648
Practice Address - Country:US
Practice Address - Phone:706-496-2856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional