Provider Demographics
NPI:1013541622
Name:CONWAY, KYLA (LIMHP, LMHP)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:LIMHP, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 L ST
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-1275
Mailing Address - Country:US
Mailing Address - Phone:308-728-4340
Mailing Address - Fax:308-728-5579
Practice Address - Street 1:2707 L ST
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-1275
Practice Address - Country:US
Practice Address - Phone:308-728-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5734101YM0800X
NE2844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health