Provider Demographics
NPI:1679161228
Name:LEWIS, KYLE AUSTIN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:AUSTIN
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 DANIELS ST
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1318
Mailing Address - Country:US
Mailing Address - Phone:740-424-8934
Mailing Address - Fax:
Practice Address - Street 1:320 MARKET ST
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2153
Practice Address - Country:US
Practice Address - Phone:740-314-5339
Practice Address - Fax:740-314-5527
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional