Provider Demographics
NPI:1578257929
Name:SPARROW, KAYLEA (LCMHCA)
Entity type:Individual
Prefix:
First Name:KAYLEA
Middle Name:
Last Name:SPARROW
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:KAYLEA
Other - Middle Name:NICOLE
Other - Last Name:SPARROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:4220 SECTION VIEW LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-9702
Mailing Address - Country:US
Mailing Address - Phone:980-215-5160
Mailing Address - Fax:
Practice Address - Street 1:4220 SECTION VIEW LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-9702
Practice Address - Country:US
Practice Address - Phone:980-215-5160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2025-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health