Provider Demographics
NPI:1578128500
Name:SPRANGLE, KYLE (LPC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:SPRANGLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S BELMONT AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6315
Mailing Address - Country:US
Mailing Address - Phone:918-758-1910
Mailing Address - Fax:918-756-1270
Practice Address - Street 1:1101 S BELMONT AVE STE 106
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6315
Practice Address - Country:US
Practice Address - Phone:918-758-1910
Practice Address - Fax:918-756-1270
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health