Provider Demographics
NPI:1518184928
Name:BLEYER, KAY (LMHC)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:BLEYER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 BLACKBIRD CT
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE BRA
Mailing Address - State:IN
Mailing Address - Zip Code:47906-6501
Mailing Address - Country:US
Mailing Address - Phone:765-426-9623
Mailing Address - Fax:
Practice Address - Street 1:211 KNOX DR
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE BRA
Practice Address - State:IN
Practice Address - Zip Code:47906-2149
Practice Address - Country:US
Practice Address - Phone:765-463-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001603A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health