Provider Demographics
NPI:1699666099
Name:PYLE, SUSAN (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:PYLE
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16898 HUNTINGTON PATH
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-4660
Mailing Address - Country:US
Mailing Address - Phone:952-451-8309
Mailing Address - Fax:
Practice Address - Street 1:2121 CLIFF DR STE 207
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3335
Practice Address - Country:US
Practice Address - Phone:952-451-8309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP7157103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling