Provider Demographics
NPI:1770824864
Name:KILEY-BOYNTON, KRISTIN (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:KILEY-BOYNTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 S ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1706
Mailing Address - Country:US
Mailing Address - Phone:913-324-3687
Mailing Address - Fax:913-780-3387
Practice Address - Street 1:480 S ROGERS RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1706
Practice Address - Country:US
Practice Address - Phone:913-324-3687
Practice Address - Fax:913-780-3387
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8587104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker