Provider Demographics
NPI:1992118079
Name:MCCLURE, KYLE (LCPC, LMAC)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:LCPC, LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-3918
Mailing Address - Country:US
Mailing Address - Phone:913-481-8132
Mailing Address - Fax:
Practice Address - Street 1:2001 E PRAIRIE CIR STE E
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5419
Practice Address - Country:US
Practice Address - Phone:913-735-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2454101Y00000X, 101YP1600X, 101YP2500X
KS25491041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty