Provider Demographics
NPI:1962372334
Name:LETOURNEAU, KAILA RAE (LPC)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:RAE
Last Name:LETOURNEAU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 KING RD
Mailing Address - Street 2:
Mailing Address - City:IMMACULATA
Mailing Address - State:PA
Mailing Address - Zip Code:19345-9903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1145 KING RD
Practice Address - Street 2:
Practice Address - City:IMMACULATA
Practice Address - State:PA
Practice Address - Zip Code:19345-9903
Practice Address - Country:US
Practice Address - Phone:484-323-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018198101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health