Provider Demographics
NPI:1174182216
Name:CRONIN, KYLE (LSW)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:CRONIN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4723
Mailing Address - Country:US
Mailing Address - Phone:412-793-7000
Mailing Address - Fax:
Practice Address - Street 1:1079 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-4723
Practice Address - Country:US
Practice Address - Phone:412-793-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health