Provider Demographics
NPI:1811359524
Name:NORMAN, KAYLA ASHLEY (ADVANCED CASAC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ASHLEY
Last Name:NORMAN
Suffix:
Gender:F
Credentials:ADVANCED CASAC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ASHLEY
Other - Last Name:BEYERBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASAC
Mailing Address - Street 1:340 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839
Mailing Address - Country:US
Mailing Address - Phone:518-926-7200
Mailing Address - Fax:518-747-8003
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-747-8001
Practice Address - Fax:518-747-8003
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)