Provider Demographics
NPI:1093435950
Name:YODER, KYLE EUGENE (LPC)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:EUGENE
Last Name:YODER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 MAXWELL HILL RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2325
Mailing Address - Country:US
Mailing Address - Phone:602-402-4185
Mailing Address - Fax:
Practice Address - Street 1:1409 MAXWELL HILL RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2325
Practice Address - Country:US
Practice Address - Phone:602-402-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional