Provider Demographics
NPI:1497632947
Name:GREEN, KYLA (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 BRADFORD PEAR DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5792
Mailing Address - Country:US
Mailing Address - Phone:972-977-6937
Mailing Address - Fax:
Practice Address - Street 1:2601 LITTLE ELM PKWY STE 302
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-1919
Practice Address - Country:US
Practice Address - Phone:469-930-4493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional