Provider Demographics
NPI:1588892376
Name:WEIR, KYLEA ANN (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:KYLEA
Middle Name:ANN
Last Name:WEIR
Suffix:
Gender:
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 KNOBCREST CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4729
Mailing Address - Country:US
Mailing Address - Phone:925-200-1835
Mailing Address - Fax:
Practice Address - Street 1:4531 NOLENSVILLE PIKE STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4751
Practice Address - Country:US
Practice Address - Phone:615-823-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7467101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7467OtherLICENSE