Provider Demographics
NPI:1194326637
Name:KAYLA WRIGHT COUNSELING, P.L.L.C.
Entity type:Organization
Organization Name:KAYLA WRIGHT COUNSELING, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ALCOHOL, DRUG, AND MH
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HIGNITE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC/MH
Authorized Official - Phone:405-837-6681
Mailing Address - Street 1:3139 SW 103RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6041
Mailing Address - Country:US
Mailing Address - Phone:405-837-6681
Mailing Address - Fax:
Practice Address - Street 1:1901 N MOORE AVE STE 15
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3612
Practice Address - Country:US
Practice Address - Phone:405-277-0482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200656680AMedicaid