Provider Demographics
NPI:1902216708
Name:HYLAND, JAMES PATRICK (LCPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:HYLAND
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:PATRICK
Other - Middle Name:
Other - Last Name:HYLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JD, MA
Mailing Address - Street 1:1319 BENTGRASS DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9096
Mailing Address - Country:US
Mailing Address - Phone:541-215-6206
Mailing Address - Fax:541-780-6967
Practice Address - Street 1:336 S SANTA FE AVE STE 4
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3934
Practice Address - Country:US
Practice Address - Phone:541-215-6206
Practice Address - Fax:541-780-6967
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC6940101YP2500X
KS03729101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500798164Medicaid