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NPI Code Detail

MEDICARE: KAYLA MEADOR COUNSELING LLC

MEDICARE: KAYLA MEADOR COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1598335820
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAYLA MEADOR COUNSELING LLC
Provider Business Mailing Address
First Line : 425 INDUSTRIAL AVE STE 201
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-2287
Country : US
Telephone Number : 304-914-1942
Fax Number :
Provider Business Practice Location Address
First Line : 425 INDUSTRIAL AVE STE 201
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-2287
Country : US
Telephone Number : 304-914-1942
Fax Number :
Authorized Official
Title or Position : CLINICAL SOCIAL WORKER
Name : KAYLA RENEE GROGG MEADOR
Credential : LICSW
Telephone Number : 304-914-1942
Provider Enumeration Date : 06/29/2021
Last Update Date : 08/11/2021

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Directions to “KAYLA MEADOR COUNSELING LLC ” Practice Location

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