Provider Demographics
NPI:1912380684
Name:JACQUELINE PYLE
Entity Type:Organization
Organization Name:JACQUELINE PYLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LBSW, IMH-E(II)
Authorized Official - Phone:269-967-2296
Mailing Address - Street 1:491 COLUMBIA AVE E
Mailing Address - Street 2:#4
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5468
Mailing Address - Country:US
Mailing Address - Phone:269-962-9611
Mailing Address - Fax:
Practice Address - Street 1:491 COLUMBIA AVE E
Practice Address - Street 2:#4
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5468
Practice Address - Country:US
Practice Address - Phone:269-962-9611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009580251S00000X
MI6802077897251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health