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General NPI Number Information
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NPI Number | 1669358248
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Entity Type | Organization
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Legal Business Name | MICHELLE KYLES DBA KALEIDOSCOPE WELLNESS LLC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 6714 PATTERSON AVE STE 101
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City | RICHMOND
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State | VA
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Zip | 23226-3432
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Country | US
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Telephone | 804-517-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 6714 PATTERSON AVE STE 101
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City | RICHMOND
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State | VA
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Zip | 23226-3432
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Country | US
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Telephone | 336-671-6605
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | TARYN ANNE FLETCHER
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Credential |
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Telephone | 804-625-0245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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