Provider Demographics
NPI:1386051456
Name:KUZEL, KYLE (LCSW)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:KUZEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-5415
Mailing Address - Country:US
Mailing Address - Phone:607-221-2095
Mailing Address - Fax:
Practice Address - Street 1:27241 STATE ROUTE 267
Practice Address - Street 2:
Practice Address - City:FRIENDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18818-8640
Practice Address - Country:US
Practice Address - Phone:607-221-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0205761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical