Provider Demographics
NPI:1174234876
Name:KYLES, LINDSEE MAE (MSW, LCSWA)
Entity type:Individual
Prefix:MRS
First Name:LINDSEE
Middle Name:MAE
Last Name:KYLES
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:MS
Other - First Name:LINDSEE
Other - Middle Name:MAE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW,LCSWA
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1904
Mailing Address - Fax:
Practice Address - Street 1:1431 FALCON RD
Practice Address - Street 2:
Practice Address - City:EAST BEND
Practice Address - State:NC
Practice Address - Zip Code:27018-8437
Practice Address - Country:US
Practice Address - Phone:336-551-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0185101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical