Provider Demographics
NPI:1114791209
Name:KYLA E WHITE LMHC PC
Entity Type:Organization
Organization Name:KYLA E WHITE LMHC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, LADC
Authorized Official - Phone:508-422-0024
Mailing Address - Street 1:300 W MAIN ST STE A4
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2132
Mailing Address - Country:US
Mailing Address - Phone:508-422-0024
Mailing Address - Fax:
Practice Address - Street 1:96 W MAIN ST STE E1
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-3810
Practice Address - Country:US
Practice Address - Phone:508-422-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty