Healthcare Provider Details

I. General information

NPI: 1396129276
Provider Name (Legal Business Name): KAYLA JANE CAIN LCSW, LCAS, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 DOLLEY MADISON RD STE 410
GREENSBORO NC
27410-5167
US

IV. Provider business mailing address

3010 W CORNWALLIS DR
GREENSBORO NC
27408-6730
US

V. Phone/Fax

Practice location:
  • Phone: 336-292-1510
  • Fax: 336-292-0679
Mailing address:
  • Phone: 828-291-7682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-21821
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC010847
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: