Provider Demographics
NPI:1396281903
Name:CHAFFIN, KYLIE (LMHC)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9921 N NEVADA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1145
Mailing Address - Country:US
Mailing Address - Phone:509-581-2690
Mailing Address - Fax:509-593-4676
Practice Address - Street 1:9921 N NEVADA ST STE 103
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1145
Practice Address - Country:US
Practice Address - Phone:509-581-2690
Practice Address - Fax:509-593-4676
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-07
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015103101YP2500X
WALH60799157101YM0800X
WAMC60669894101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional