Provider Demographics
NPI:1215294806
Name:BELLINGER, KYLE (MED, LPC)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:BELLINGER
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1619
Mailing Address - Country:US
Mailing Address - Phone:607-857-6240
Mailing Address - Fax:
Practice Address - Street 1:1150 GRANT ST
Practice Address - Street 2:SUITE 7
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2834
Practice Address - Country:US
Practice Address - Phone:607-857-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health