Provider Demographics
NPI:1093524787
Name:FERROLY, KYLE STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:STEVEN
Last Name:FERROLY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W311S570 HIDDEN HOLW
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-3262
Mailing Address - Country:US
Mailing Address - Phone:414-426-4673
Mailing Address - Fax:
Practice Address - Street 1:625 WALNUT RIDGE DR STE 120
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8801
Practice Address - Country:US
Practice Address - Phone:414-426-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor