MEDICARE: KIMBERLY LAYTON

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1790663565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY LAYTON

Provider Business Mailing Address
First Line	:	209 FINAL STRETCH LN
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-3920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	377 RUBIN CENTER DR STE 101
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7284
Country	:	US
Telephone Number	:	803-547-7238
Fax Number	:

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

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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Directions to “ KIMBERLY LAYTON ” Practice Location

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