Provider Demographics
NPI:1306324249
Name:MORALES, KAYLA CRYSTAL (LMSW)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:CRYSTAL
Last Name:MORALES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SIMPSON ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-1801
Mailing Address - Country:US
Mailing Address - Phone:646-281-6032
Mailing Address - Fax:
Practice Address - Street 1:2825 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4066
Practice Address - Country:US
Practice Address - Phone:718-520-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-10-18
Deactivation Date:2022-08-24
Deactivation Code:
Reactivation Date:2022-10-14
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY109850-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker