Provider Demographics
NPI:1558889584
Name:TOWNS, KAITLYN R (LPC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:R
Last Name:TOWNS
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:NIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:99 CRACKER BARREL DR
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1650
Mailing Address - Country:US
Mailing Address - Phone:304-525-7851
Mailing Address - Fax:
Practice Address - Street 1:55 DONOHOE DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-8887
Practice Address - Country:US
Practice Address - Phone:304-525-7851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2296101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1558889584Medicaid