MEDICARE: KYLIE HARMON LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCC.0020319	CO

General Provider Information

NPI Number	:	1003522095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE HARMON LPCC

Provider Business Mailing Address
First Line	:	10364 EVENING VISTA DR
Second Line	:
City	:	PEYTON
State	:	CO
Zip	:	80831-8316
Country	:	US
Telephone Number	:	423-946-1273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3616 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80917
Country	:	US
Telephone Number	:	719-357-7504
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	01/24/2023

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