Provider Demographics
NPI:1962249789
Name:HUBERTY, KYLEE (LCSW)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:HUBERTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10080 GOLER WASH CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3027
Mailing Address - Country:US
Mailing Address - Phone:775-304-7949
Mailing Address - Fax:
Practice Address - Street 1:537 RALSTON ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4434
Practice Address - Country:US
Practice Address - Phone:775-298-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10570-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical