Healthcare Provider Details

I. General information

NPI: 1598636086
Provider Name (Legal Business Name): KYLIE CARINA FLORES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 10/24/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 ROUTE 146
CLIFTON PARK NY
12065-3689
US

IV. Provider business mailing address

359 BALLSTON AVE
SARATOGA SPRINGS NY
12866-4723
US

V. Phone/Fax

Practice location:
  • Phone: 518-881-0560
  • Fax:
Mailing address:
  • Phone: 518-587-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number128105
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: