Provider Demographics
NPI:1740893007
Name:WINKLER, KYLE MATTHEW (LCSW)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:MATTHEW
Last Name:WINKLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GALA DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1098
Mailing Address - Country:US
Mailing Address - Phone:845-527-7365
Mailing Address - Fax:
Practice Address - Street 1:466 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2534
Practice Address - Country:US
Practice Address - Phone:845-843-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0973021041C0700X
COCSW.099309141041C0700X
NY108084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker