Provider Demographics
NPI:1669048500
Name:STAPLES, KAYLA (LCSW)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LEE CT
Mailing Address - Street 2:
Mailing Address - City:FORT LEONARD WOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65473-8017
Mailing Address - Country:US
Mailing Address - Phone:802-738-3888
Mailing Address - Fax:
Practice Address - Street 1:120 W PENNSYLVANIA AVE STE 54
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5429
Practice Address - Country:US
Practice Address - Phone:910-446-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker