Provider Demographics
NPI:1942364237
Name:SHERWOOD, KAYLA JOY (MA, LMHC, CPC)
Entity Type:Individual
Prefix:
First Name:KAYLA JOY
Middle Name:
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:MA, LMHC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26345 SE 156TH PL
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8241
Mailing Address - Country:US
Mailing Address - Phone:425-369-2933
Mailing Address - Fax:
Practice Address - Street 1:26345 SE 156TH PL
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8241
Practice Address - Country:US
Practice Address - Phone:425-369-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health