Provider Demographics
NPI:1275930125
Name:KYLE, LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KYLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 S HEBRON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-4048
Mailing Address - Country:US
Mailing Address - Phone:812-471-1776
Mailing Address - Fax:812-469-2000
Practice Address - Street 1:655 S HEBRON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-4048
Practice Address - Country:US
Practice Address - Phone:812-471-1776
Practice Address - Fax:812-469-2000
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002537A1041C0700X
IN87001167A101YA0400X
IN35000359A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist