Provider Demographics
NPI:1386159747
Name:CLAYTON, KAYLA ANNE (LCSW, APSW)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ANNE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:LCSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5062 ROCKROSE CT STE 78
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-7797
Mailing Address - Country:US
Mailing Address - Phone:815-708-7411
Mailing Address - Fax:
Practice Address - Street 1:9853 N ALPINE RD # 202
Practice Address - Street 2:
Practice Address - City:MACHESNEY PARK
Practice Address - State:IL
Practice Address - Zip Code:61115-1681
Practice Address - Country:US
Practice Address - Phone:815-708-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0167691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical