MEDICARE: KYLIE SIMON

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	101YM0800X	Mental Health Counselor	APC001391	PA

General Provider Information

NPI Number	:	1891624631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE SIMON

Provider Business Mailing Address
First Line	:	5328 BUTLER ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-2674
Country	:	US
Telephone Number	:	412-781-3990
Fax Number	:	412-781-3966

Provider Business Practice Location Address
First Line	:	5328 BUTLER ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-2674
Country	:	US
Telephone Number	:	412-781-3990
Fax Number	:	412-781-3966

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ KYLIE SIMON ” Practice Location

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