Provider Demographics
NPI:1235938085
Name:NESTER, MIKAYLA SHAE (MA, LPA, HSP-PA)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:SHAE
Last Name:NESTER
Suffix:
Gender:
Credentials:MA, LPA, HSP-PA
Other - Prefix:
Other - First Name:SHAE
Other - Middle Name:
Other - Last Name:NESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPA, HSP-PA
Mailing Address - Street 1:1100 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1830
Mailing Address - Country:US
Mailing Address - Phone:336-334-5312
Mailing Address - Fax:
Practice Address - Street 1:1100 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1830
Practice Address - Country:US
Practice Address - Phone:336-334-5312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program