Healthcare Provider Details

I. General information

NPI: 1013671213
Provider Name (Legal Business Name): KYLE FRANCOIS MENETRIER DEVRIES LMHC, LPC, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 E 2ND ST
TULSA OK
74104-2110
US

IV. Provider business mailing address

3116 E 2ND ST
TULSA OK
74104-2110
US

V. Phone/Fax

Practice location:
  • Phone: 918-200-9862
  • Fax:
Mailing address:
  • Phone: 405-837-1044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.61463109
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC12386
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: