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General NPI Number Information
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NPI Number | 1609580919
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Entity Type | Individual
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Provider Name | NICHOLAS KYLE PROCTOR LCMHCA
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Gender | Male
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 301 E MEETING ST
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City | MORGANTON
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State | NC
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Zip | 28655-3593
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Country | US
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Telephone | 828-437-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1416 PRINCE ST
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City | HICKORY
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State | NC
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Zip | 28602-9789
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A18313
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A18313
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License Number State | NC
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