Provider Demographics
NPI:1154025526
Name:STILES, KAYLEE (LAC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:STILES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 ALVIN SLOAN AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4171
Mailing Address - Country:US
Mailing Address - Phone:908-635-6282
Mailing Address - Fax:
Practice Address - Street 1:492 ROUTE 57 W
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4411
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00820500101YM0800X
NJ2023-000111101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)