Provider Demographics
NPI:1477040673
Name:HULSEBUS, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HULSEBUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MURRAY AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1657
Mailing Address - Country:US
Mailing Address - Phone:412-463-7941
Mailing Address - Fax:
Practice Address - Street 1:6315 FORBES AVE STE B014
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1700
Practice Address - Country:US
Practice Address - Phone:412-212-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7034-125101YM0800X
PAPC011392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health