Provider Demographics
NPI:1396196119
Name:WINLOW, KYLA (LCSW)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:WINLOW
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 1:1206 ELEANOR ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-2118
Mailing Address - Country:US
Mailing Address - Phone:512-554-1798
Mailing Address - Fax:
Practice Address - Street 1:4807 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BLDG 1, #1140
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8444
Practice Address - Country:US
Practice Address - Phone:512-843-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX578451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical