MEDICARE: KYLE WILLIAM THOMPSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6401010346	MI

General Provider Information

NPI Number	:	1669681326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE WILLIAM THOMPSON LPC

Provider Business Mailing Address
First Line	:	802 GRAND PRE AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49006-2944
Country	:	US
Telephone Number	:	269-344-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 GRAND PRE AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49006-2944
Country	:	US
Telephone Number	:	269-344-0930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	06/15/2015

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Directions to “ KYLE WILLIAM THOMPSON LPC” Practice Location

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