Provider Demographics
NPI:1861278285
Name:KAUFMAN, KYLA CLAUDETTE (LPC)
Entity type:Individual
Prefix:MS
First Name:KYLA
Middle Name:CLAUDETTE
Last Name:KAUFMAN
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 1:3404 NW 178TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9150
Mailing Address - Country:US
Mailing Address - Phone:405-651-8332
Mailing Address - Fax:
Practice Address - Street 1:3404 NW 178TH ST STE B
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-9150
Practice Address - Country:US
Practice Address - Phone:405-651-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional