Healthcare Provider Details

I. General information

NPI: 1639583537
Provider Name (Legal Business Name): KAYLLE TOWERS M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HADLEY GROVE DR
MOSCOW MILLS MO
63362-1500
US

IV. Provider business mailing address

112 HADLEY GROVE DR
MOSCOW MILLS MO
63362-1500
US

V. Phone/Fax

Practice location:
  • Phone: 217-313-6086
  • Fax:
Mailing address:
  • Phone: 217-313-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.016455
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025029467
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: