Provider Demographics
NPI:1669865903
Name:KYLE CORSIGLIA, MFT
Entity Type:Organization
Organization Name:KYLE CORSIGLIA, MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORSIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:415-255-3253
Mailing Address - Street 1:2171 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4003
Mailing Address - Country:US
Mailing Address - Phone:415-255-3253
Mailing Address - Fax:
Practice Address - Street 1:2171 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4003
Practice Address - Country:US
Practice Address - Phone:415-255-3253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT39244305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service