MEDICARE: EMILY KYLE 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	101YM0800X	Mental Health Counselor	LPC03869	KS

General Provider Information

NPI Number	:	1922671833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY KYLE LPC

Provider Business Mailing Address
First Line	:	3711 ELIZABETH CT
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-4165
Country	:	US
Telephone Number	:	785-215-3002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 WAKARUSA DR STE E229
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-3883
Country	:	US
Telephone Number	:	785-215-3002
Fax Number	:

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

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	07/19/2021

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