Individual
KYLE FORREST RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC, LPC-MH
Contact information
Practice address
200 LINDEN ST, WESTFIELD, IA 51062-7727
(712) 540-4090
Mailing address
2098 GLENN ELLEN RD, SERGEANT BLUFF, IA 51054-8078
(712) 540-4090
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
092334
IA
101Y00000X
Counselor
LPC-MH30835
SD
101YM0800X
Mental Health Counselor
Primary
092334
IA
101YM0800X
Mental Health Counselor
LPC-MH30835
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092334
IA LICENSE NUMBER
IA
01
—
LPC-MH30835
SD LICENSE NUMBER
SD
Enumeration date
06/28/2018
Last updated
01/09/2024
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