Healthcare Provider Details

I. General information

NPI: 1447732789
Provider Name (Legal Business Name): KYLA SALMOND LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 11/24/2024
Certification Date: 11/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6277 A1A S STE 202
ST AUGUSTINE FL
32080-7515
US

IV. Provider business mailing address

609 CEDAR BOUGH CT
ST AUGUSTINE FL
32080-6580
US

V. Phone/Fax

Practice location:
  • Phone: 386-227-7874
  • Fax:
Mailing address:
  • Phone: 386-227-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: