Provider Demographics
NPI:1902601081
Name:ARGO, KAYLA SHIANNE (LCSW)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:SHIANNE
Last Name:ARGO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 DAVIDS HOME CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:COMER
Mailing Address - State:GA
Mailing Address - Zip Code:30629-1602
Mailing Address - Country:US
Mailing Address - Phone:706-680-2072
Mailing Address - Fax:
Practice Address - Street 1:2350 PRINCE AVE STE 3
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6039
Practice Address - Country:US
Practice Address - Phone:706-225-9516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0094101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty