Provider Demographics
NPI:1982362208
Name:COMPTON, KYLE DAVID
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:DAVID
Last Name:COMPTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1731
Mailing Address - Country:US
Mailing Address - Phone:270-399-5980
Mailing Address - Fax:
Practice Address - Street 1:1970 BARRET CT STE 123
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-4944
Practice Address - Country:US
Practice Address - Phone:270-777-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health