Individual
KAYLA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
615 N 18TH ST STE 101, LAFAYETTE, IN 47904-3413
(765) 423-5361
(765) 742-8272
Mailing address
3511 S 9TH ST, LAFAYETTE, IN 47909-3545
(765) 423-5361
(765) 742-8272
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99077229A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13938925
CAQH
IN
01
—
34008518A
LCSW
IN
01
—
99077229A
LSW
IN
Enumeration date
01/13/2017
Last updated
11/14/2019
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