Basic Information
Provider Information
NPI: 1821638503
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CELAYA
FirstName: TWYLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 1832
Address2:  
City: PITTSBURG
State: KS
PostalCode: 667621832
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3011 N MICHIGAN ST
Address2:  
City: PITTSBURG
State: KS
PostalCode: 667622546
CountryCode: US
TelephoneNumber: 6202319873
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/10/2020
LastUpdateDate: 11/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X829KSN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X3549KSY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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