Provider Demographics
NPI:1750050712
Name:WAKELEY, KAELIN (LPC, CMHC)
Entity type:Individual
Prefix:
First Name:KAELIN
Middle Name:
Last Name:WAKELEY
Suffix:
Gender:F
Credentials:LPC, CMHC
Other - Prefix:
Other - First Name:KAELIN
Other - Middle Name:
Other - Last Name:CLOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMHC
Mailing Address - Street 1:131 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4833
Mailing Address - Country:US
Mailing Address - Phone:724-822-3110
Mailing Address - Fax:
Practice Address - Street 1:11883 PERRY HWY STE D
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7353
Practice Address - Country:US
Practice Address - Phone:724-987-2993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-12
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC018080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty