Provider Demographics
NPI:1659457828
Name:HOPKINS, KYLE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KYLE
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BEACH ST
Mailing Address - Street 2:BLDG B
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2717
Mailing Address - Country:US
Mailing Address - Phone:401-596-6866
Mailing Address - Fax:401-596-0493
Practice Address - Street 1:85 BEACH ST
Practice Address - Street 2:BLDG. B
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2717
Practice Address - Country:US
Practice Address - Phone:401-596-6866
Practice Address - Fax:401-596-0493
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW014041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKH46168Medicaid