Provider Demographics
NPI:1568285864
Name:HEMMING, KAYLA MARIE (LAC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:HEMMING
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 1:48 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3464
Mailing Address - Country:US
Mailing Address - Phone:973-897-3358
Mailing Address - Fax:
Practice Address - Street 1:163 ENGLE ST STE 2
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2530
Practice Address - Country:US
Practice Address - Phone:201-350-7352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00828500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health