Provider Demographics
NPI:1871039941
Name:BEARY, KAYLA M (LPCC-S)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:BEARY
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:M
Other - Last Name:BUTCHECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 BOARDMAN CANFIELD RD STE L1
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4370
Mailing Address - Country:US
Mailing Address - Phone:330-330-8655
Mailing Address - Fax:
Practice Address - Street 1:725 BOARDMAN CANFIELD RD STE L1
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4370
Practice Address - Country:US
Practice Address - Phone:330-330-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901049-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional