Provider Demographics
NPI:1316161623
Name:KYLE, KIMBERLEE (MA,LPC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEE
Middle Name:
Last Name:KYLE
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3777
Mailing Address - Country:US
Mailing Address - Phone:281-332-9931
Mailing Address - Fax:
Practice Address - Street 1:620 W MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3777
Practice Address - Country:US
Practice Address - Phone:281-332-9931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11588101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health