Provider Demographics
NPI:1043957566
Name:PIZZOLATTO, KAYLA (LPC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:PIZZOLATTO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 HIGHWAY 304 LOT 2
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-7325
Mailing Address - Country:US
Mailing Address - Phone:985-856-3197
Mailing Address - Fax:
Practice Address - Street 1:509 SAINT MARY ST STE H
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-2639
Practice Address - Country:US
Practice Address - Phone:985-242-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8469101Y00000X, 101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)