Provider Demographics
NPI:1992314538
Name:AUSTIN, KYLE L (LMHC, LPC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:L
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 IRVING AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-2535
Mailing Address - Country:US
Mailing Address - Phone:347-585-7648
Mailing Address - Fax:
Practice Address - Street 1:46 IRVING AVE APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-2535
Practice Address - Country:US
Practice Address - Phone:347-585-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health