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Organization
KIYLA MENTAL CLINIC LLC
Active
Organization
KIYLA MENTAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS BRADY STARK (ED)
(812) 801-1352
Entity
Organization
Contact information
Practice address
2387 PROFESSIONAL HEIGHTS DR STE 140, LEXINGTON, KY 40503-3056
(859) 303-5794
(859) 303-5390
Mailing address
617 HAVANA CT, LEXINGTON, KY 40511-8852
(859) 303-5794
(859) 303-5390
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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