Kayla S Fanguy, LPC, LMFT
Individual provider Active NPI Marriage & Family Therapist · Lafayette, LA
NPI 1104145507 · NPPES record last updated May 25, 2010
Key facts
- NPI
- 1104145507
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 1129 (LA)
- Practice address
- 4540 Ambassador Caffery Pkwy
BLDG. D, Suite B-220
Lafayette, LA 70508-6928 - Phone
- (337) 981-2180
- Fax
- (337) 981-2391
- NPI assigned
- May 25, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3986 | LA | MD | Dentist |
| 1129 | LA | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 3986 | LA | |
| Marriage & Family Therapist | 106H00000X | 1129 | LA | Yes |
Addresses
Primary practice location
4540 Ambassador Caffery Pkwy
BLDG. D, Suite B-220
Lafayette, LA 70508-6928
Mailing address
4540 Ambassador Caffery Pkwy
BLDG. D, Suite B-220
Lafayette, LA 70508-6928
Phone (337) 981-2180
Other providers in Lafayette, LA
- Family Circle Inc.
- Family Circle, Inc.
- Family Circle, Inc.
- Family Health Clinic
- Family Pharmacy Service, Inc
- Farhana Amir, MD
- Farkas Crna, LLC
- Patricia J. Farkas
- Ryan Patrick Farmer
- Grace Farnell
All providers in Lafayette, LA · Marriage & Family Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.