Healthcare Provider Details

I. General information

NPI: 1306753538
Provider Name (Legal Business Name): KAILEY LYN PERKINS CANO LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 17TH ST NW
WASHINGTON DC
20010-1882
US

IV. Provider business mailing address

3509 17TH ST NW
WASHINGTON DC
20010-1882
US

V. Phone/Fax

Practice location:
  • Phone: 281-734-0277
  • Fax:
Mailing address:
  • Phone: 281-734-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLG200007965
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: