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NPI Code Detail

MEDICARE: KYLE CORDLE

MEDICARE: KYLE CORDLE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCAPRE.195940OH
2171M00000XCase Manager/Care Coordinator
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1609753995
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE CORDLE
Provider Business Mailing Address
First Line : 827 N MAIN ST
Second Line :
City : MARION
State : OH
Zip : 43302-1736
Country : US
Telephone Number : 740-914-5000
Fax Number :
Provider Business Practice Location Address
First Line : 827 N MAIN ST
Second Line :
City : MARION
State : OH
Zip : 43302-1736
Country : US
Telephone Number : 740-914-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2025
Last Update Date : 06/03/2026

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Directions to “ KYLE CORDLE ” Practice Location

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