Provider Demographics
NPI:1851507040
Name:KILLIAN, KYLE D (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:D
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-5037
Mailing Address - Country:US
Mailing Address - Phone:513-560-2409
Mailing Address - Fax:
Practice Address - Street 1:62 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-5037
Practice Address - Country:US
Practice Address - Phone:513-523-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist