Healthcare Provider Details

I. General information

NPI: 1578081683
Provider Name (Legal Business Name): KYRA HAGLUND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S BEVERLY DR STE 307
BEVERLY HILLS CA
90212-4309
US

IV. Provider business mailing address

108 S JACKSON ST
SEATTLE WA
98104-3802
US

V. Phone/Fax

Practice location:
  • Phone: 310-279-7284
  • Fax:
Mailing address:
  • Phone: 310-279-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: