Provider Demographics
NPI:1699924142
Name:DARNALL, KYLE THOMAS (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:THOMAS
Last Name:DARNALL
Suffix:
Gender:M
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 1:1900 CENTRACARE CIR # 2475
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-4977
Mailing Address - Fax:320-229-5110
Practice Address - Street 1:1900 CENTRACARE CIR # 2475
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-4977
Practice Address - Fax:320-229-5110
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5117103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling