Healthcare Provider Details

I. General information

NPI: 1699690818
Provider Name (Legal Business Name): KYRA BEVENOUR PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S HIGH ST
WEST CHESTER PA
19382-3262
US

IV. Provider business mailing address

333 LANCASTER AVE APT 910
MALVERN PA
19355-1830
US

V. Phone/Fax

Practice location:
  • Phone: 267-856-1071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: