Healthcare Provider Details

I. General information

NPI: 1124932199
Provider Name (Legal Business Name): KAYLA F MCCLATCHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 OLD CASSATT RD STE 100
BERWYN PA
19312-1152
US

IV. Provider business mailing address

177 BROOKLEA RD
BRYN MAWR PA
19010-1005
US

V. Phone/Fax

Practice location:
  • Phone: 610-510-8646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: