Provider Demographics
NPI:1992342760
Name:SPADING, KYLE ROBERT (LMHC, CRC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:ROBERT
Last Name:SPADING
Suffix:
Gender:M
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 S DUBUQUE ST APT 105
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4319
Mailing Address - Country:US
Mailing Address - Phone:319-350-0921
Mailing Address - Fax:
Practice Address - Street 1:628 S DUBUQUE ST APT 105
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4319
Practice Address - Country:US
Practice Address - Phone:319-961-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-29
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095634101YM0800X
225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor