Provider Demographics
NPI:1922644699
Name:DOYLE, DENNIS DEAN (LPC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:DEAN
Last Name:DOYLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 LITTLE BLUE PKWY STE 360
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-8317
Mailing Address - Country:US
Mailing Address - Phone:816-373-9243
Mailing Address - Fax:
Practice Address - Street 1:4200 LITTLE BLUE PKWY STE 360
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-8317
Practice Address - Country:US
Practice Address - Phone:816-373-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2017034992101YP2500X
MO2017034992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty