Provider Demographics
NPI:1801338876
Name:SIEFERT, KAYLA MARIE I (LMFT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:SIEFERT
Suffix:I
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:RITENOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2000 COOMBS FARM RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1126
Mailing Address - Country:US
Mailing Address - Phone:304-381-2211
Mailing Address - Fax:
Practice Address - Street 1:2000 COOMBS FARM RD STE 106
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1126
Practice Address - Country:US
Practice Address - Phone:304-381-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
WV9106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist