Healthcare Provider Details

I. General information

NPI: 1760890461
Provider Name (Legal Business Name): KAYLA GENE STERLING MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 S MAIN ST
LIMA OH
45804-1500
US

IV. Provider business mailing address

1718 CARDINAL ST
WORLAND WY
82401-4235
US

V. Phone/Fax

Practice location:
  • Phone: 307-388-8528
  • Fax:
Mailing address:
  • Phone: 307-347-6165
  • Fax: 307-347-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPCSW-595
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2203707
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: