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General NPI Number Information
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NPI Number | 1063022291
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Entity Type | Individual
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Provider Name | KAYLA DAWN CHILTON LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 14072 ELKIN HIGHWAY 268
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City | RONDA
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State | NC
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Zip | 28670-9199
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Country | US
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Telephone | 336-827-0089
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Fax | 844-676-0500
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Provider Business Mailing Address
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Address Line | 2341 N OAK RIDGE CHURCH RD
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City | BOONVILLE
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State | NC
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Zip | 27011-9007
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Country | US
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Telephone | 336-710-2671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A20076
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A20076
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License Number State | NC
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