Provider Demographics
NPI:1639447139
Name:SPEARS, KYLE SHEA (LMFT LIMHP)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:SHEA
Last Name:SPEARS
Suffix:
Gender:M
Credentials:LMFT LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 N 109TH PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1722
Mailing Address - Country:US
Mailing Address - Phone:402-403-0190
Mailing Address - Fax:402-932-4121
Practice Address - Street 1:638 N 109TH PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1722
Practice Address - Country:US
Practice Address - Phone:402-403-0190
Practice Address - Fax:402-932-4121
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE167106H00000X
NE1457101YM0800X
IA374106H00000X
IA15057101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)