Individual
KYLE MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP / LPC
Contact information
Practice address
9029 SIENNA RANCH ROAD, MISSOURI CITY, TX 77459
(281) 399-4767
Mailing address
PO BOX 966, FRESNO, TX 77545-0966
(281) 399-4767
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4292
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4292
LICENSED PROFESSIONAL COUNSELOR - MENTAL HEALTH SERVICE PROVIDER (LPC-MHSP)
TN
01
—
84129
LICENSED PROFESSIONAL COUNSELOR LPC
TX
Enumeration date
06/19/2019
Last updated
09/28/2020
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