Healthcare Provider Details

I. General information

NPI: 1679241228
Provider Name (Legal Business Name): KAYLA KIND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29414 RIVER VIEW PKWY
BURLINGTON WI
53105-7605
US

IV. Provider business mailing address

29414 RIVER VIEW PKWY
BURLINGTON WI
53105-7605
US

V. Phone/Fax

Practice location:
  • Phone: 262-500-3141
  • Fax:
Mailing address:
  • Phone: 262-500-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8230-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: