Individual provider Active NPI

Kayla Marie Carlyle, LLMSW

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1790361749
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801109178 Issued in MI
Practice address
4287 Five Oaks Dr
Lansing, MI 48911-4214
Phone
(513) 882-4000
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801109178 MI Primary

Addresses

Primary practice location

4287 Five Oaks Dr
Lansing, MI 48911-4214

Mailing address

1855 W Shore Dr Apt A1
East Lansing, MI 48823-7607
Phone (740) 503-5097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801109178MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1790361749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W SHORE DR APT A1",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237607",
            "telephone_number": "740-503-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4287 FIVE OAKS DR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114214",
            "telephone_number": "513-882-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLYLE",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801109178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.