Provider Demographics
NPI:1396498283
Name:TEMPLE, KAYLA LEIGH (LPC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:LEIGH
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WILD RUN RD
Mailing Address - Street 2:
Mailing Address - City:BARTO
Mailing Address - State:PA
Mailing Address - Zip Code:19504-9217
Mailing Address - Country:US
Mailing Address - Phone:610-761-5038
Mailing Address - Fax:
Practice Address - Street 1:800 HERITAGE DR STE 810
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9220
Practice Address - Country:US
Practice Address - Phone:610-761-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6460292101YS0200X
PAPC014077101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool