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General NPI Number Information
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NPI Number | 1447294947
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Entity Type | Individual
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Provider Name | HEATH KILGORE PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2925 W 49TH ST
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City | WESTWOOD
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State | KS
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Zip | 66205-1717
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Country | US
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Telephone | 602-405-4161
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 W 49TH ST
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City | WESTWOOD
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State | KS
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Zip | 66205-1717
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Country | US
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Telephone | 602-405-4161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY-003781
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-003781
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY-003781
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PSY-003781
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License Number State | AZ
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