Provider Demographics
NPI:1225263387
Name:HINTON, KYLE ERIC SR (MA, CAAC)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:ERIC
Last Name:HINTON
Suffix:SR
Gender:M
Credentials:MA, CAAC
Other - Prefix:MR
Other - First Name:KYLE
Other - Middle Name:ERIC
Other - Last Name:HINTON
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:MA, CAAC
Mailing Address - Street 1:4475 SPRINGMONT
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-5375
Mailing Address - Country:US
Mailing Address - Phone:616-540-6393
Mailing Address - Fax:
Practice Address - Street 1:4475 SPRINGMONT DR SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-5375
Practice Address - Country:US
Practice Address - Phone:616-540-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)