Provider Demographics
NPI:1972197432
Name:TULEY, KYRA (LCSW, TCADC)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:TULEY
Suffix:
Gender:F
Credentials:LCSW, TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 STARK ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1499
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5966 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-0387
Practice Address - Country:US
Practice Address - Phone:270-904-5104
Practice Address - Fax:270-201-5980
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2578471041C0700X
TN87941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical