Healthcare Provider Details

I. General information

NPI: 1962027862
Provider Name (Legal Business Name): KAYLA CUMPTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 ARDUSER DR
OSCEOLA MO
64776-6278
US

IV. Provider business mailing address

835 NE 450 RD
OSCEOLA MO
64776-6348
US

V. Phone/Fax

Practice location:
  • Phone: 417-646-5075
  • Fax:
Mailing address:
  • Phone: 660-464-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2022046559
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: