Doctor Name: | KYLE JAMES SMITH |
NPI Number: | 1023350154 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, NCC |
License Number: | 178.008437 |
Business Practice Address: | 721 S Quentin Rd Ste. 103 Palatine, IL - 600676778 |
Business Phone Number: | 8473597490 |
Business Fax Number: | 8473597525 |
Mailing Address: | 721 S Quentin Rd Ste 103, The Bridge Youth & Family Services PALATINE |
State: | IL |
Postal Code: | 600676778 |
Phone Number: | 8473597490 |
Fax Number: | 8473597525 |
NPI Enumeration Date: | 03/27/2013 |
NPI Last Update Date: | 03/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 178.008437 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |