Provider Demographics
NPI:1730661398
Name:CAGLE, KAY LYNN (LPC CANDIDATE)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:LYNN
Last Name:CAGLE
Suffix:
Gender:F
Credentials:LPC CANDIDATE
Other - Prefix:MRS
Other - First Name:KAY
Other - Middle Name:LYNN
Other - Last Name:CAGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:K CAGLE LLC
Mailing Address - Street 1:12384 RENICK RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OK
Mailing Address - Zip Code:73448-7211
Mailing Address - Country:US
Mailing Address - Phone:405-206-6408
Mailing Address - Fax:
Practice Address - Street 1:301 W MAIN ST STE 307
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6322
Practice Address - Country:US
Practice Address - Phone:405-206-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health