Provider Demographics
NPI:1831580992
Name:MILLER, KAYLA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:BOOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2225 PACIFIC BLVD SE STE 108
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-7903
Mailing Address - Country:US
Mailing Address - Phone:541-321-6327
Mailing Address - Fax:
Practice Address - Street 1:2225 PACIFIC BLVD SE STE 108
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-7903
Practice Address - Country:US
Practice Address - Phone:541-321-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor