Provider Demographics
NPI:1669928446
Name:HAY, KAITLYN O'CONNOR (MA, LPC, NCC, CCTP2)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:O'CONNOR
Last Name:HAY
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CCTP2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 STOREHOUSE LN UNIT CD
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3822
Mailing Address - Country:US
Mailing Address - Phone:985-603-8082
Mailing Address - Fax:
Practice Address - Street 1:7 STOREHOUSE LN UNIT CD
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3822
Practice Address - Country:US
Practice Address - Phone:985-603-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
LA7561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist