MEDICARE: KAYLA BYRD MC, LPC

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
1	101Y00000X	Counselor	18998	AZ
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1760091136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA BYRD MC, LPC

Provider Business Mailing Address
First Line	:	7330 N 16TH ST STE C115
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-8209
Country	:	US
Telephone Number	:	727-753-8145
Fax Number	:

Provider Business Practice Location Address
First Line	:	7330 N 16TH ST STE C115
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-8209
Country	:	US
Telephone Number	:	727-753-8145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	01/13/2025

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