Provider Demographics
NPI:1245886282
Name:NUNLEY, KAILA-LEIGH TESTERMAN (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:KAILA-LEIGH
Middle Name:TESTERMAN
Last Name:NUNLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 PERRYVILLE DR
Mailing Address - Street 2:
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21902-1111
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:
Practice Address - Street 1:59 AVE D
Practice Address - Street 2:364
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25277104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker