Kayla Noelle Theberge, LPC
Counselor, Professional in Saint Louis, MO. Individual provider (NPI-1).
NPI number1013676865
StatusActive
Last updated in NPPESApr 8, 2024
Details
- NPI
- 1013676865
- Entity type
- Individual (NPI-1)
- Name
- Kayla Noelle Theberge
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2021
- Certification date
- Apr 8, 2024
- Last updated
- Apr 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2021046281 | MO | Yes |
Practice location
10024 Office Center Ave Ste 100Saint Louis, MO 63128-1392
Phone 314-729-7050
Mailing address
1601 Old South River RdSaint Charles, MO 63303-4120
Phone 636-246-1210
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